On postoperative day 3 following open colectomy, a 68-year-old male develops a temperature of 38.8°C, productive cough, and tachypnea. Chest auscultation reveals right lower lobe crackles and bronchial breath sounds. What is the most likely cause of fever?
Answer and explanation
Correct answer: A. Hospital-acquired postoperative pneumonia
- Step 1: Postoperative fever causes follow the mnemonic 'Wind (days 1-2, atelectasis), Water (day 3, UTI), Wound (days 4-5, surgical site infection), Walking (days 5-7, DVT/PE), Wonder drugs'.
- Step 2: Productive cough, fever on day 3, and localized pulmonary consolidation confirm hospital-acquired pneumonia.
- Step 3: Wound infections typically manifest on postoperative days 4 through 7.
Answer
Hospital-acquired postoperative pneumonia.
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