Drug-induced fever in post-surgical patients: a systematic review of case reports

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-...

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Main Authors: Fatemeh Afra, Mona Aboutalebzadeh, Soheila Tayefeh, Sepide Javankiani, Bita Shahrami, Amir Ahmad Arabzadeh
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Therapeutic Advances in Drug Safety
Online Access:https://doi.org/10.1177/20420986251335825
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author Fatemeh Afra
Mona Aboutalebzadeh
Soheila Tayefeh
Sepide Javankiani
Bita Shahrami
Amir Ahmad Arabzadeh
author_facet Fatemeh Afra
Mona Aboutalebzadeh
Soheila Tayefeh
Sepide Javankiani
Bita Shahrami
Amir Ahmad Arabzadeh
author_sort Fatemeh Afra
collection DOAJ
description 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.
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spelling doaj-art-55a54ecee92e41e08f654ab84a2e36902025-08-20T02:28:50ZengSAGE PublishingTherapeutic Advances in Drug Safety2042-09942025-05-011610.1177/20420986251335825Drug-induced fever in post-surgical patients: a systematic review of case reportsFatemeh AfraMona AboutalebzadehSoheila TayefehSepide JavankianiBita ShahramiAmir Ahmad ArabzadehBackground: 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.https://doi.org/10.1177/20420986251335825
spellingShingle Fatemeh Afra
Mona Aboutalebzadeh
Soheila Tayefeh
Sepide Javankiani
Bita Shahrami
Amir Ahmad Arabzadeh
Drug-induced fever in post-surgical patients: a systematic review of case reports
Therapeutic Advances in Drug Safety
title Drug-induced fever in post-surgical patients: a systematic review of case reports
title_full Drug-induced fever in post-surgical patients: a systematic review of case reports
title_fullStr Drug-induced fever in post-surgical patients: a systematic review of case reports
title_full_unstemmed Drug-induced fever in post-surgical patients: a systematic review of case reports
title_short Drug-induced fever in post-surgical patients: a systematic review of case reports
title_sort drug induced fever in post surgical patients a systematic review of case reports
url https://doi.org/10.1177/20420986251335825
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