1. A 36 year old woman with a stricture of the ileum secondary to Crohn's disease underwent a laparotomy for correction of the stricture. On the evening after the surgery the surgical intern received a call from the floor nurse in charge of the patient saying that he had a fever spike of 102 F. All the following are possible causes of the fever except
1. The inflammatory stimulus of surgery.
2. Surgical site infection
3. Septic peritonitis
4. Drug induced fever

Answer: The answer is (b). The potential causes of fever in the immediate operative and postoperative period are mainly limited to: medications or blood products to which the patient was exposed during preoperative care, in the operating room or in the recovery area; trauma suffered prior to surgery or as part of surgery; and infections that were present prior to surgery. The septic peritonitis could possibly have been pre existent given the condition of ileal stricture.