Cefazolin-Related Fever in Postoperative Spine Surgery: A Case Report
Sirichai Wilartratsami MD*, Pinpilai Jutasompakorn MD**, Panya Luksanapruksa MD*
Affiliation : * Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : There have been few reports describing antibiotic related fever, especially in the beta-lactam class of antibiotics.
The present report is a case of postoperative immediate-onset cefazolin-related fever in a lumbar spine surgery patient.
Case Report : A 58-year-old woman presented with progressive low back pain and neurogenic claudication of both extremities
for six months. Magnetic resonance imagese (MRI) of the lumbar spine indicated central canal stenosis with nerve root
compression from L4 to S1. After decompressive laminectomy, pedicular screw fixation, and posterolateral fusion were
performed, the patient experienced postoperative fever without obvious evidence of infection. The blood and tip of drain
bacterial culture grew no organisms. After propholactic cefazolin was discontinued in postoperative day 5, the fever began to
declined and returned to normal on postoperative day 9.
Conclusion : Postoperative drug fever that is caused by prophylactic cefazolin may be delayed in diagnosis because drug
fever is usually diagnosed by exclusion after the elimination of other potential causes. The research authors would like to
encourage physicians to be aware of this entity. Prompt cause identification can obviate unnecessary diagnostic procedures
and inappropriate treatments.
Keywords : Drug fever, Cefazolin, Cephazolin, Cephalosporin, Adverse event, Spine surgery
