Early Postoperative Fever in Pediatric Oncology Patients Undergoing Solid Tumor Resection
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Key Takeaways
- 42% of pediatric oncology patients develop fever within 48 hours post-tumor resection, but only 2.8% have true infection
- Infected patients were hemodynamically unstable with positive blood cultures—infection was clinically obvious, not subtle
- Routine fever workups cost ~$500/patient and lead to unnecessary empiric antibiotics in one-third of cases
- Fever alone in first 48 hours post-resection may not warrant full septic workup—reserve for hemodynamic instability
- Clinical stability is key: stable vitals + isolated fever likely does not require aggressive intervention or antibiotics
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Your patient's post-op day one from a hepatoblastoma resection, and they spike a fever. Do you think they need a big fever workup? Hi, my name's Sophia Skmore. I'm from Cincinnati Children, and I'm going to share a study with you today that says maybe they don't. A Study of 220 oncology patients found that 42% of them had a fever in the 48 hours following tumor resection. However, of these patients, only two of them, so 2.8%, had an actual infection, and those Patients were hemodynamically unstable with positive blood cultures, so it wasn't very subtle. Meanwhile, most fevers triggered a workup that costs on average about $500 a patient, and about a third of patients got empiric antibiotics that they didn't need. So here's the big takeaway. In the 48 hours following a tumor resection, a fever alone may not be a reason to panic. Save the big workup for your patients that are hemodynamically unstable or who have more overt signs of infection.