A 55-Year-Old Man Undergoes a Conventional Pancreaticoduodenectomy (Whipple Procedure) for Suspected

A 55-year-old man undergoes a conventional pancreaticoduodenectomy (Whipple procedure) for suspected pancreatic adenocarcinoma of the head of the pancreas.  Prior to the procedure, the patient receives a dose of prophylactic antibiotics.  Toward the end of the operation, he is given 2 units of packed red blood cells.  The patient is then extubated and transferred to the postanesthesia care unit for recovery.  One hour later, he develops fever and chills.  Temperature is 38.5 C (101.3 F) , blood pressure is 130/76 mm Hg, pulse is 90/min, and respirations are 16/min.  The patient is mildly sedated but responds to commands appropriately.  Examination shows a mildly tender abdominal wound without erythema.  There is serosanguinous discharge from the pancreatic suction drain.  The lungs are clear to auscultation.  A Foley catheter and right subclavian central venous access are present, both placed at the time of surgery.  Which of the following is the most likely cause of this patient's fever?

A) Catheter-associated infection
B) Drug fever from antibiotic
C) Malignant hyperthermia
D) Pulmonary embolism
E) Surgical site infection
F) Transfusion reaction

Correct Answer:

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