ABSTRACT
A number of common events may occur after transfer of patients from intensive care to the ward. They are considered below.
Pyrexia Differential diagnosis of postoperative pyrexia requires careful clinical assessment of
the likely source of infection supplemented by microbiological examination of appropriate specimens (sputum, urine, stool, venous blood, indwelling cannulae, wound exudate). A high index of suspicion must be maintained, coupled with prompt investigations, particularly in the presence of valvular prosthesis/synthetic materials/conduits. Antibiotic treatment should be culture-directed and commenced according to clinical need. Leukocytosis (neutrophilia), tachycardia, rigors and sweats and persistent pyrexia indicate significant sepsis and need for early treatment. Prolonged (>7 days) and mutiple-agent therapy may be required in some situations (infective endocarditis, sternal osteomyelitis, mediastinal sepsis).
