An otherwise healthy 42-year-old male undergoes an uncomplicated open appendectomy for acute appendicitis. Approximately 24 hours after the procedure, the nursing staff notes a new-onset temperature of 38.4°C (101.1°F). The patient reports mild incisional pain but denies dyspnea, cough, dysuria, or calf pain. Blood pressure is 128/76 mm Hg, pulse is 88/min, and respirations are 16/min. The surgical dressing is dry and intact, with no surrounding erythema. Auscultation of the chest reveals diminished breath sounds over both lung bases. Which of the following is the most likely etiology of this patient's elevated temperature?
- ASurgical site infection
- BUrinary tract infection
- AtelectasisAnswer
- DDeep vein thrombosis
- EDrug-induced fever
Answer
Atelectasis is the most likely cause of this patient's early postoperative fever.
Atelectasis is the collapse of alveoli, which frequently occurs early in the postoperative period due to shallow breathing, pain, or prolonged recumbency. It is the most common cause of fever on postoperative days 1 to 2. The clinical presentation of a low-grade fever combined with diminished breath sounds at the lung bases exactly 24 hours after surgery makes atelectasis the most likely etiology.
Step-by-Step Solution
Key Concept
The most common cause of fever within the first 24 to 48 hours postoperatively is atelectasis.
Estimated Time:45s