Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. Accessed Feb. 9, 2022. You can take simple steps to prevent an infection. Procedures by selected patient characteristicsNumber by procedure category and age. information is beneficial, we may combine your email and website usage information with The presence of anemia, whether pre- or postoperatively, reduces the bloods oxygen carrying capacity and increases the risk for AKI. Generally speaking, a normal oral temperature for a resting, healthy adult is about 98.6F (37C). Kidney dysfunction in the postoperative period. Fever. Some surgeons begin antibiotics before the culture results are available, and some prescribe antibiotics for all of their surgery patients. Infant fever (older than age 90 days). The initial imaging test of choice is a supine and upright abdominal x-ray to differentiate between POI and bowel obstruction or perforation. painful urination. https://www.uptodate.com/contents/search. You could also place the thermometer under your armpit instead. A single copy of these materials may be reprinted for noncommercial personal use only. Blood transfusion and the risk of atrial fibrillation after cardiac surgery. https://www.merckmanuals.com/professional/infectious-diseases/biology-of-infectious-disease/fever. We aim to cover other common postoperative complications, such as acute renal failure, postoperative gastrointestinal complications, anemia, fever, and delirium that often contribute to longer lengths of stay, rising health care costs, and increased morbidity and mortality for patients. Elsevier; 2020. https://www.clinicalkey.com. Fever. One of the most common side effects of surgery is fever. Merck Manual Professional Version. The best way to manage your risk for developing high blood pressure after surgery is to discuss a plan with your doctor. Update on perioperative acute kidney injury. Up to 102 F (38.9 C) taken rectally for children ages 2-3, or taken orally for children older than 3. These are the other signs and symptoms for specific types of SSI: A superficial incisional SSI may produce pus from the wound site. When the nose . However, "normal" can vary based on age, race, and other factors. A fever is considered low-grade if your temperature is 1 or 2 degrees above the normal reading of 98.6 degrees. Febrile seizures fact sheet. Perioperative acute kidney injury: an under-recognized problem. The 2014 Society of Ambulatory Anesthesia (SAMBA) guidelines provide a framework to identify at-risk patients, and to prevent and treat PONV. Rheumatic fever is a complex disease that affects the joints, skin, heart, blood vessels, and brain. Have you or your child recently traveled outside the country? many: There can be many causes, the most common after surgery is atelectasis due to poor inspiration. Call your health care provider if your temperature is 103 F (39.4 C) or higher. Millichap JJ. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). A fever this high could mean you have a serious infection. If you have a fever and your incision isn't healing well, tell your surgeon right away. Basic laboratory studies that should be obtained include complete blood count; electrolytes including calcium, magnesium, and potassium; creatinine; liver enzymes; and lactate. In cardiac surgery, a recommended transfusion threshold of 7.5 g/dL exists based on a number of randomized, controlled trials. Other types of thermometers, such as ear (tympanic membrane) or forehead (temporal artery) thermometers, although convenient, provide less accurate temperature measurements. Iron therapy in the postoperative setting has been studied, particularly in orthopedic surgery. It's a good idea to let your surgeon know if you have a low-grade fever. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. https://www.uptodate.com/contents/search. Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults. Fevers generally go away within a few days. Bennett JE, et al. Preoperative risk factors for postoperative delirium. Fevers above 102 F (38.9 C) tend to cause discomfort and often require treatment. Mayo Clinic. Read the full transcript. Balanced crystalloid solutions (electrolyte composition resembling plasma) may be preferred over normal saline to avoid hyperchloremic acidosis, which can cause renal vasoconstriction and reduced glomerular filtration rate. Scott Sundick, MD, is board-certified in general surgery and vascular surgery. Risk of pre-and post-operative delirium and the delirium elderly at risk (dear) tool in hip fracture patients. As noted above, preoperative hemoglobin should be optimized ideally to normal range for age and sex or reasonable goal of greater than 12.0 g/dL. About a third of the children who have one febrile seizure will have another one, most commonly within the next 12 months. You may be able to prevent fevers by reducing exposure to infectious diseases. In a 2013 Cochrane Database systematic review of interventions to prevent perioperative kidney injury, there was no benefit in mortality or acute renal injury for various pharmacologic interventions, including dopamine, diuretics, calcium channel blockers, ACE inhibitors, N-acetyl cysteine, atrial natriuretic peptide, sodium bicarbonate, antioxidants, or erythropoietin. Posted by joyce1 @joyce1, Feb 25, 2017. That's because these medications typically lower fever and treat pain at the same time. Practice Management Guidelines for Stress Ulcer Prophylaxis. https://www.uptodate.com/contents/search. This site complies with the HONcode standard for trustworthy health information: verify here. They may include: Antibiotics for bacterial and parasitic infections. It's one part of an overall response from the body's immune system. Ward MA. Chronic kidney disease and postoperative mortality: a systematic review and meta-analysis. Typical body temperature is a balance of heat production and heat loss. Symptoms. having hypothyroidism, which causes more sensitivity to cold. A fever can be alarming when you are recovering from surgery. Your health care provider may prescribe other medications based on the cause of your illness. If your child seems uncomfortable, give your child acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others). . https://www.merckmanuals.com/professional/infectious-diseases/biology-of-infectious-disease/fever. Ear or forehead thermometers, although convenient, provide less accurate temperature measurements. All rights reserved. Take nasal or throat samples to test for respiratory infections. To provide you with the most relevant and helpful information, and understand which Patient blood management: recommendations from the 2018 Frankfurt Consensus Conference. Read the label carefully for proper dosage, and be careful not to take more than one medication containing acetaminophen, such as some cough and cold medicines. About 15% of people will experience a fever after the second dose of these vaccines. Melatonin for the prevention of postoperative delirium in older adults: a systematic review and meta-analysis. information and will only use or disclose that information as set forth in our notice of Managing anemia in the postoperative setting must be individualized. Delirium: a symptom of how hospital care is failing older persons and a window to improve quality of hospital care. High-grade fevers range from about 103 F-104 F. Fever after surgery is generally not considered dangerous. Treatment and prognosis of febrile seizures. Prevention of POI is ideal and can be facilitated by epidural anesthesia rather than general anesthesia (if feasible), reduction in intraoperative and postoperative opioid use, minimization of direct intestinal trauma perioperatively, and using a minimally invasive surgical approach. American Academy of Pediatrics; 2021. AskMayoExpert. Gastrointestinal stress-related mucosal disease (SRMD) is another perioperative complication that clinicians should be cognizant of, and similar to POI, prevention of SRMD is the ideal goal. Common causes are listed in. In general, though, when there is no nerve damage, the long-term outcome for surgical and non . Exposure to cold. By Jennifer Whitlock, RN, MSN, FN Acute kidney injury and chronic kidney disease as interconnected syndromes. This prompts complex processes that produce more heat and restrict heat loss. Pathophysiology and treatment of fever in adults. Wash your hands before and after touching your incision. All rights reserved. A febrile seizure may involve loss of consciousness, shaking of limbs on both sides of the body, eyes rolling back or body stiffness. Have you or your child been around anyone who's ill? Medication isn't needed. Accessed Feb. 9, 2022. Delirium: a key challenge for perioperative care. Aclinical prediction rule for delirium after elective noncardiac surgery. These thermometers provide the most accurate measurement of core body temperature. The. A topical systematic review. Last medically reviewed on January 9, 2018. . Call the doctor if the fever doesn't respond to the medication, is consistently 103 F (39.4 C) or higher, or lasts longer than three days. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. It can be lower in the morning and higher in the late afternoon and evening. Dinarello CA, et al. Millichap JJ. Yet there are some circumstances when you should seek medical advice for your baby, your child or yourself. Merck Manual Professional Version. Medication isn't needed. Call your care provider if your fever doesn't improve, even after taking medication. Fever in infants and children: Pathophysiology and management. Fever. Patients with known CKD have a particularly high risk for major adverse cardiac events with increased morbidity and mortality. information and will only use or disclose that information as set forth in our notice of having anemia. Prevention of delirium in hospitalized older patients: risk factors and targeted intervention strategies. 2017;32(2):124-129. doi:10.1177/0885066615625194, Rao J, Singh A. What Is the Recovery Time for Appendicitis Surgery? In fact, fevers seem to play a key role in fighting infections. Call the doctor if the fever is accompanied by a severe headache, stiff neck, shortness of breath, or other unusual signs or symptoms. Periprocedural effects of statins on the incidence of contrast-induced acute kidney injury: a systematic review and meta-analysis of randomized controlled trials. Here are some tips that can help: Mayo Clinic does not endorse companies or products. Pediatric Telephone Protocols: Office Version. But you don't necessarily need to treat a fever if it's not causing discomfort. Evaluating postoperative fever: a focused approach. A multimodal analgesic regimen should be employed to reduce opioid use. Relation of Use of Red Blood Cell Transfusion After Acute Coronary Syndrome to Long-Term Mortality. Do statins induce or protect from acute kidney injury and chronic kidney disease: an update review in 2018. Intravenous iron for treatment of anemia in the 3 perisurgical phases: a review and analysis of the current literature. Above 102 F (38.9 C) taken rectally for children ages 2-3, or taken orally for children older than 3. Fight coronavirus (COVID-19) transmission at home. Keep in mind that children should also avoid hot or cold drinks if you're taking their temperature by mouth. Spinal fusion connects two or more bones in the spine to make it more stable, correct a problem or reduce pain. Accessed Feb. 7, 2022. U.S. Centers for Disease Control and Prevention. Knowledge of differential diagnosis, as well as a systematic approach, proves useful in narrowing down the differential diagnosis and instituting proper management. Comparative evaluation of plain films, ultrasound and CT in the diagnosis of intestinal obstruction. U.S. Center for Disease Control and Prevention. There are several patient-specific and procedure-specific factors that have been shown to increase PONV risk. If you have had a hot or cold drink, wait 20 minutes. [1][2] DEAR MAYO CLINIC: I've had an awful cold for months. If your child is age 6 months or older, ibuprofen (Advil, Motrin, others) is OK, too. Efficacy of short-term high-dose statin pretreatment in prevention of contrast-induced acute kidney injury: updated study-level meta-analysis of 13 randomized controlled trials. Surgical adverse events: a systematic review. Phase I: guidelines for preventing hospital-acquired infections. Call the doctor if the fever is accompanied by a severe headache, stiff neck, shortness of breath, or other unusual signs or symptoms. Accessed March 25, 2020. For a fever, some basic questions to ask your provider include: Don't hesitate to ask other questions during your appointment as they occur to you. Mayo Clinic does not endorse companies or products. You may also need specialized wound care. But even after surgery, many people with chronic sinusitis still require ongoing treatment, such as . 16th ed. 2021;160(6):e623-e628. Is medicine necessary to lower the fever? Make a donation. 2018;5(6). Antiviral medications for viral infections. Interventions for protecting renal function in the perioperative period. One must keep in mind that bacterial infections in this timeframe will be due to more indolent micro-organisms such as coagulase-negative staphylococci. Management of delirium focuses on identifying reversible causes and emphasizing reorientation in a stable environment with consistency of staff and location. Cystitis or infection of the bladder. These common conditions are frequently seen in hospital and can contribute to longer lengths of stay and rising health care costs. In this Article. Thank you, {{form.email}}, for signing up. A fever is a particular cause for concern in infants and toddlers. Consensus guidelines for the management of postoperative nausea and vomiting. Depending on what's causing a fever, other fever signs and symptoms may include: Sweating. This content does not have an Arabic version. Iron deficiency anemia is common in the postoperative setting. The DSM-5 criteria, level of arousal and delirium diagnosis: inclusiveness is safer. Preoperatively, clinicians should discuss the patients wishes regarding dialysis in the event renal function worsens unexpectedly. sneezing, sore throat, watery eyes and a fever. You may need antibiotics or another treatment. Others wait until a test shows that antibiotics are necessary. The SALT Randomized Trial. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. Temperature regulation and the pathogenesis of fever. Infant fever (age 60 days or younger). Long-term risk of mortality and acute kidney injury during hospitalization after major surgery. Fevers below 104 F (40 C) associated with common viral infections, such as the flu, may help the immune system fight disease and are generally not harmful. Postoperative fever is defined as a temperature higher than 38 C (or greater than 100.4 F) on two consecutive postoperative days or higher than 39 C (or greater than 102.2 F) on any postoperative day. Taking your temperature daily in the week after surgery is a smart and easy way to keep an eye on your health as you recover. COVID-19: Who's at higher risk of serious symptoms? J Intensive Care Med. In: Nelson Textbook of Pediatrics. Order tests, such as blood tests or a chest X-ray, as needed, based on your medical history and physical exam. Read the label carefully for proper dosage, and be careful not to give your child more than one medication containing acetaminophen, such as some cough and cold medicines. 17th ed. All rights reserved. Common causes are listed in Table 5. https://www.emergencyphysicians.org/article/know-when-to-go/fever. Stiff neck and pain when you bend your head forward, Mental confusion, strange behavior or altered speech, Certain inflammatory conditions such as rheumatoid arthritis inflammation of the lining of your joints (synovium), Some medications, such as antibiotics and drugs used to treat high blood pressure or seizures, Some immunizations, such as the diphtheria, tetanus and acellular pertussis (DTaP), pneumococcal or COVID vaccine, Lay your child on the side or stomach on the floor or ground, Remove any sharp objects that are near your child, Don't place anything in your child's mouth or try to stop the seizure, Call 911 or your local emergency number if a seizure lasts more than five minutes or your child doesn't appear to recover well after the seizure. Accessed March 25, 2020. This site complies with the HONcode standard for trustworthy health information: verify here. Encourage your child to rest and drink plenty of fluids. Hypoglycemia. An example is when the spine curves sideways, also known as scoliosis. Electronic chart review as an aid to postdischarge surgical site surveillance: increased case finding. Treatments vary depending on the underlying cause. It takes a very long time to regain strength in atrophied muscle and it has been close to 2 and half years since the fracture. Can you get a fever after tooth extraction? Don't give aspirin to children, because it may trigger a rare, but potentially fatal, disorder known as Reye's syndrome. Postoperative Fever Evaluation Following Lumbar Fusion Procedures. Mayo Clinic; 2020. The device tells your care provider how the heart is beating while you do your daily activities. Although alarming for parents, the vast majority of febrile seizures cause no lasting effects. SAMBA consensus guidelines for the management of postoperative nausea and vomiting: an executive summary for perianesthesia nurses. Accessed Feb. 7, 2022. Internal Medicine - Pulmonary Critical Care 22 years experience. Your healthcare team can do tests to determine exactly what's causing the problem. Pain. Are there any restrictions that I need to follow? You may opt-out of email communications at any time by clicking on Low-Grade Fever. This is normal. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html. Blood transfusion requirement and not preoperative anemia are associated with perioperative complications following intracorporeal robot-assisted radical cystectomy. It is normal to have chills after surgery. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. When and how to wash your hands. What, if anything, seems to improve the symptoms? Signs and symptoms of malignant hyperthermia may vary and can occur during anesthesia or during recovery shortly after surgery. AskMayoExpert. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. You can try a number of things to make yourself or your child more comfortable during a fever: Your appointment may be with your family doctor, pediatrician or other care provider. Verywell Health's content is for informational and educational purposes only. General Anaesthesia. 2017;25(3):2309499017727953. doi:10.1177/2309499017727953, Meier K, Lee K. Neurogenic fever: Review of pathophysiology, evaluation, and management. Identifying these risk factors, while addressing and optimizing modifiable risks, can mitigate the likelihood of developing these postoperative complications. Several prediction tools for the development of delirium have been described previously. If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. Acute postoperative fever is defined as fever occurring within the first week after surgery. Accessed Feb. 7, 2022. According to the Mayo Clinic, fever after surgery is a symptom of staph infection. Derivation and validation of a preoperative prediction rule for delirium after cardiac surgery. information submitted for this request. Chest. Anemia is another common complication in the postoperative setting, occurring in up to 80% to 90% of individuals undergoing major surgery. Call your child's health care provider if your child: Ask your child's health care provider for guidance in special circumstances, such as a child with immune system problems or with a preexisting illness. These medications will usually lower your temperature, but you may still have a mild fever. Additionally, insufficient evidence yet exists to support these restrictive guidelines in patients with acute coronary syndrome, severe thrombocytopenia (as higher red blood cell volume increases platelet effectiveness), and chronic transfusion-dependent anemia. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Febrile-Seizures-Fact-Sheet. It's also called a cardiac event recorder. Three male attending vascular surgeons participated in eleven . An infection is never "normal" after a procedure and immediate treatment can prevent serious complications. Approach to fever or suspected infection in the normal host. Review/update the Click here for an email preview. What, if anything, appears to worsen the symptoms? Medication isn't needed. So far, no significant benefit has been found with the initiation of oral iron therapy in the postoperative setting. Given the differential of immediate postoperative fever, one does not need to obtain blood cultures or chest x-rays in this scenario. Postoperative complications are common. Postoperative complications are often due to the interplay of multiple factors. Surgery was ruled out and it was . Post-operative fever in orthopaedic surgery: How effective is the 'fever workup?' POI is typically a self-limited physiologic response lasting up to 72 hours postoperatively. I'm tagging fellow members @yoanne @lyndylou @frande @carsangelop @dp52350 @cindym1960 @777darla and @grandmajan who have mitral valve repair experience in the hopes they may be able to share their experiences with surgery and post surgical recovery.. MKX, you said that you have the mitral valve surgery in July 2019, but that the fevers started in . These include female sex, history of PONV, history of motion sickness, nonsmoking status, younger age, usage of general anesthesia, usage of volatile anesthetics or nitrous oxide, the duration of anesthesia, postoperative opioid use, and specific surgical types (cholecystectomy, gynecologic surgeries, and laparoscopy). Mayo Clinic Minute: You're washing your hands all wrong. Give your child acetaminophen (Tylenol, others). Systematic review and meta-analysis of chewing-gum therapy in the reduction of postoperative paralytic ileus following gastrointestinal surgery. A culture allows your healthcare team to identify which bacteria are growing in a sample of tissue or fluid. Predictive model and interrelationship with baseline vulnerability. A number of over-the-counter medications lower a fever. Fevers after surgery may be accompanied by other infection symptoms, including chills, shivering or sweating. Other less-effective and less- used options include sucralfate (a cytoprotective agent) and prostanoids (such as misoprostol, which decrease gastric acid and bolsters mucosal defenses). Mucus may build up in your lungs. 1. Major guidelines have been published on stratifying and managing adverse cardiovascular events and thromboembolic events, but there is often less literature supporting management of other, more common, postoperative complications, including acute kidney injury, gastrointestinal complications, postoperative anemia, fever, and delirium. "Perianal fistulas are a complex medical condition that, even when repaired surgically, can reoccur, causing a lot of suffering for patients," says William Faubion Jr., M.D., a gastroenterologist and senior author on the study."Our hope with this research is to advance a cell-based therapy toward daily clinical care that would be easy to implant in the operating room and offer a new option for . Many times, fever is a natural bodily defense against infection. High potassium levels (hyperkalemia) or low potassium levels (hypokalemia). Liberal or restrictive transfusion in high-risk patients after hip surgery. Like. Methods for decreasing postoperative gut dysmotility. Reducing baseline risk includes using regional anesthesia rather than general anesthesia if possible, use of total intravenous anesthesia with propofol, avoidance of nitrous oxide, avoidance of volatile anesthetics, minimization of perioperative opioid use, and ensuring adequate hydration. U.S. Centers for Disease Control and Prevention. These medications are used to bring down your fever. Treating the underlying cause may lessen signs and symptoms, including fever. doi:10.1016/j.chest.2021.07.049. . Mayo Clinic research finds hope in stem cell therapy for perianal fistulas in patients with Crohn's disease. You may need to take some steps to resolve the problem. The risk factors for many postoperative complications include both patient and surgery-specific variables. Accessed Feb. 7, 2022. A review. Accessed April 8, 2020. It occurs mainly in children between the ages of 5 to 15. Incidence of adverse events and negligence in hospitalized patients. For the first 24 hours, apply ice to your jaw for 30 minutes, remove it for 15 minutes, then do it again. Most cases are harmless . Antibiotics. nausea or vomiting that won't stop. In patients with well-controlled blood pressure, providers should hold angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, and diuretics preoperatively. Common surgical complications, including thrombotic and cardiopulmonary events, have been addressed in prior articles in this perioperative series. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). A fever that persists after a surgical procedure is a sign that staph is in the bloodstream, which is a serious condition that may become life-threatening. How severe are they? Prevalence and outcomes of anemia in surgery: a systematic review of the literature. To update your cookie settings, please visit the, Thematic review on perioperative medicine, 76-Year-Old Woman With Syncope and Right-Sided Weakness, Centers for Disease Control and Prevention, US Department of Health and Human Services, American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults, Assessment and Management of Patients With Perioperative Renal Disease, Risk Factors for the Development of Perioperative Acute Kidney Injury, Management of Patients With Gastrointestinal Complications, Assessment and Management of Postoperative Nausea and Vomiting, Medication Options for the Prevention and Treatment of PONV, Assessment and Management of Postoperative Ileus, Assessment and Management of Postoperative Gastrointestinal Stress Ulcers, Eastern Association for the Surgery of Trauma, Management of Patients With Perioperative Anemia, Intravenous Iron Formulations and Dosing (Off-Label Use), Diagnosis and Management of Patients With Postoperative Fever, Management of Patients With Postoperative Delirium, European Delirium Association, American Delirium Society, eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiJhMzM4MDU2MjE2YTBhMGEyMmVlOTc3MTEyMmQ5ZTAwNCIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjc3OTUzMDQyfQ.bGeRwTlPEV8OeJzcFCc8MdPH4w9b_BiRxEENMsUmc58y3Y_gu112joV0Hs8yGLPSWwpMTHhyL6hwPml7R1zXc0P6vPD5GQqeBFpSVEZUJSC7nm2kaBXbUxG_VyMEBG1ZeJ8krWlnRwTu2cXiKNwREmh4tYtti3nJCY_dlmnuWtBLzC0uTcbB6F6IpaWLEtgxSxawaFUtGf3pA8Heb2-5oPwJk4zRK3ggdyPoBTxgVgqH-Y8JkdZVMzJl2aJopokkYs1gO3kMVLw718LPJ2JtJh7Kb_kZDno2CDa5_lAZFhJ2exnwzlFdrEqC15b9bL_6zC5kflBrX2d-7EHY-D7PEA, https://doi.org/10.1016/j.mayocp.2020.03.008, Management of Common Postoperative Complications, Diagnostic and Statistical Manual of Mental Disorders, Monitor glucose; short duration not associated with wound infection/healing; tumor lysis can occur (rare), QT prolongation; risk of sudden cardiac death, Dimenhydrinate, meclizine, or diphenhydramine, Sedation; extrapyramidal effects; most effective class for opioid-induced nausea and vomiting, Propofol, clonidine, mirtazapine, gabapentin, benzodiazepines, or metoclopramide, Varying efficacy; various side effects including sedation, confusion, fall risk, and respiratory depression, Hydrocortisone dose equivalence of >250 mg, Up to 300 mg slow intravenous push or diluted in 100-250 mL normal saline, 125 mg diluted in 100 mL normal saline over 60 min daily for 5 doses maximum per wk, 510 mg rapid intravenous push for 2 doses 3-8 d apart, 750 mg intravenous infusion or intravenous push for 2 doses 1 wk apart, Immediate postoperative fever (intraoperatively or hours after surgery), Acute postoperative fever (within the first week after surgery), Subacute postoperative fever (between 1 and 4 weeks after surgery), Delayed postoperative fever (more than 4 weeks after surgery), Bacterial infections (typically indolent types).