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Drug-induced fever in post-surgical patients: a systematic review of case reports
Fatemeh Afra1,2, Mona Aboutalebzadeh1, Soheila Tayefeh1
1Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Background:
Fever is a common postoperative complication, typically caused by aseptic inflammation or infection. However, drug-induced fever (DIF) is an underdiagnosed etiology that should be considered in the differential diagnosis, especially in patients receiving complex medication regimens post-surgery.
Objectives:
This systematic review aims to assess the current literature on DIF in post-surgical patients to improve diagnostic accuracy and patient care.
Design:
Systematic review of case reports and case series.
Data Sources And Methods:
This systematic review was conducted following the PRISMA 2020 guidelines. We included case reports and series involving post-surgical patients with fever linked to drug administration. Studies were retrieved from the PubMed, Scopus, Embase, and Web of Science databases, as well as gray literature sources. Quality and bias were assessed using the Joanna Briggs Institute (JBI) critical appraisal tools.
Results:
A total of 16 studies (14 case reports and 2 case series) involving 23 patients were included. The most frequently implicated drugs were propofol, morphine, and cephalosporins. Fever onset ranged from immediate postoperative to several days later, with varied patterns, including intermittent, remittent, and continuous fever. The majority of patients recovered after drug discontinuation, although two cases resulted in death.
Conclusion:
DIF is one of the causes of postoperative fever. Early identification and cessation of the offending drug are crucial for resolving the fever and preventing severe complications. Clinicians must remain vigilant in diagnosing DIF to improve patient outcomes post-surgery.
Insights
Drug-induced fever (DIF) is an underdiagnosed cause of postoperative fever. Promptly identifying and stopping the causative drug is key to patient recovery and preventing complications.
Area of Science:
- Pharmacology
- Clinical Medicine
- Medical Diagnostics
Background:
- Fever is a common postoperative complication.
- Drug-induced fever (DIF) is an underdiagnosed cause of postoperative fever.
- Complex medication regimens increase the risk of DIF in surgical patients.
Purpose of the Study:
- To systematically review the literature on drug-induced fever in post-surgical patients.
- To enhance diagnostic accuracy for postoperative fever.
- To improve patient care for surgical patients experiencing fever.
Main Methods:
- Systematic review of case reports and case series following PRISMA 2020 guidelines.
- Literature search across PubMed, Scopus, Embase, and Web of Science databases.
- Quality and bias assessment using Joanna Briggs Institute (JBI) critical appraisal tools.
Main Results:
- 16 studies (23 patients) were included.
- Propofol, morphine, and cephalosporins were the most implicated drugs.
- Most patients recovered after drug discontinuation; two cases resulted in death.
Conclusions:
- Drug-induced fever is a significant cause of postoperative fever.
- Early identification and drug cessation are critical for patient outcomes.
- Clinician vigilance is essential for diagnosing and managing DIF.
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