Perioperative Infections and Fever

Perioperative fever has multiple possible etiologies, including infections such as pneumonia, fungal infections, and those related to urinary or central venous catheters. By understanding the typical time frame and common risk factors for each etiology, hospitalists and other perioperative consultants can develop a differential diagnosis for perioperative fever. The following module will provide a general approach for determining the differential diagnosis in patients with a perioperative fever, as well as an outline of the diagnostic and treatment modalities.

To provide hospitalists and other perioperative consultants with a general approach to evaluating and treating patients with perioperative fever, especially those due to pulmonary infections, urinary and central venous catheter-related infections, and fungal infections.

This activity is designed for hospitalists and other perioperative consultants. No prerequisites required.

After completing the module, the participant should be able to:

1. Develop a differential diagnosis for patients with a perioperative fever based on the timing of the fever.
2. Evaluate diagnostic and treatment strategies for postoperative pneumonia.
3. Evaluate diagnostic and treatment strategies for postoperative urinary catheter-related infection.
4. Evaluate diagnostic and treatment strategies for postoperative central venous catheter-related infection.
5. Evaluate diagnostic and treatment strategies for postoperative fungal infection.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

Accreditation Statement: The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide CME for physicians.

Credit Designation Statement: The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 2 AMA PRA Category 1 Credit(s)^™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release date: February 15, 2009. Expiration date: February 15, 2013.

Estimated time to complete activity: 2 hours

Full Disclosure Policy Affecting CME Activities: As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of The Johns Hopkins University School of Medicine to require the disclosure of the existence of any relevant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The presenting faculty reported the following:

^*Clinical Associate Professor of Medicine, Clinical Assistant Professor of Obstetrics/Gynecology, University of Medicine and Dentistry of New Jersey—Robert Wood Johnson Medical School, New Brunswick, New Jersey; Director of Research/Outcomes, Jersey Shore University Medical Center, Department of Medicine, Neptune, New Jersey.

^†Clinical Assistant Professor of Medicine, Robert Wood Johnson Medical School, Department of Medicine, New Brunswick, New Jersey; Jersey Shore University Medical Center, Neptune, New Jersey.

Conflict of Interest: Dr Carson reports having no relevant financial or advisory relationships with corporate organizations related to this activity; Dr Liu reports receiving honorarium and serving on the speakers’ bureau for Pfizer Inc.

Off-Label Product Discussion: All faculty have indicated that they have not referenced unlabeled or unapproved uses of drugs or devices.

Disclaimer: The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of The Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

Address correspondence to: Michael P. Carson, MD, Director of Research/Outcomes, Jersey Shore University Medical Center, Department of Medicine, Ackerman 3, 1945 Route 33, Neptune, NJ 07753. E-mail: MPCarson@meridianhealth.com.

Click here to download the references for this educational activity.

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 5 sections: an unaccredited pre-test, a study activity, and a CME post-test. All 5 sections must be completed to receive CME credit.