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Related Experiment Videos

[Non infectious postoperative fever].

A Perren1, G Merlani, M Previsdomini

  • 1Interdisziplinäre Intensivstation, Ospedale Regionale Bellinzona e Valli, Bellinzona.

Praxis
|April 17, 2007
PubMed
Summary
This summary is machine-generated.

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Prolonged postoperative fever in a gastrectomy patient was unexplained for 47 days. The patient recovered rapidly after diagnosis and treatment of Addison crisis with hydrocortisone, highlighting non-infectious causes.

Area of Science:

  • Gastroenterology
  • Endocrinology
  • Critical Care Medicine

Background:

  • Subtotal gastrectomy for adenocarcinoma can lead to prolonged postoperative fever.
  • Infectious causes account for only about half of postoperative fever cases.
  • Fever arising later than 48 hours post-surgery necessitates excluding infectious origins.

Observation:

  • A 74-year-old man developed unexplained prolonged fever for 47 days post-gastrectomy.
  • The patient's condition deteriorated, requiring ICU transfer due to lethargy, hemodynamic instability, lung edema, and abdominal symptoms.
  • Diagnosis of Addison crisis was established based on clinical presentation.

Findings:

  • Hydrocortisone substitution therapy led to rapid resolution of all symptoms.

Related Experiment Videos

  • This case highlights the importance of considering non-infectious etiologies for prolonged postoperative fever.
  • Addison crisis can manifest with non-specific symptoms, including prolonged fever.

    • Implications:

    • Extended differential diagnosis beyond infections is crucial for prolonged postoperative fever.
    • Fever of unknown origin (FUO) protocols should be considered in complex postoperative cases.
    • Early recognition and treatment of Addison crisis can prevent severe complications.