Objective:

To illustrate the diagnostic pitfalls of postoperative fever in orthopedic patients, particularly distinguishing drug-induced fever from infectious causes.

Approach:

• Case Presentation: A 49-year-old male with a comminuted femoral fracture developed postoperative fever, initially suspected to be necrotizing fasciitis, but later diagnosed as drug-induced fever.

Key Findings:

• Postoperative fever can arise from various causes, including drug-induced fever, which may mimic infection.
• The patient was treated with broad-spectrum antibiotics based on initial suspicion of necrotizing fasciitis.
• A systematic exclusion of infectious sources and drug withdrawal led to the diagnosis of antimicrobial-associated drug fever.

Interpretation:

This case illustrates the importance of recognizing drug-induced fever to prevent unnecessary antibiotic use.

Limitations:

• The case study is based on a single patient, which may limit the applicability of the findings to broader populations.
• Potential confounding factors in the patient's clinical history may not have been fully explored.

Conclusion:

Recognizing drug-induced fever is essential for optimizing antibiotic use in postoperative care.