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Maternal febrile morbidity is classically defined as temperatures exceeding 100.4 on at
least two occasions, at least 6 hours apart.
For patients with an obvious infection
and high fever, localizing signs and septic in
appearance, begin treatment immediately without waiting for the 6-hour
definition to be fulfilled.
Cultures from the urine and
vagina (and sometimes
blood) can be useful. Similarly, a
chest x-ray,
may identify a pulmonary cause for the fever..
 Examine the patient, looking for localizing signs that will guide you in your therapy.
Check for:
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Uterine tenderness, suggesting a uterine or endometrial source
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Flank tenderness, suggesting pyelonephritis
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Breast tenderness and redness, suggesting mastitis
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Perineum tenderness and redness, suggesting wound infection
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Pulmonary rales, rhonchi or wheezes, suggesting a respiratory source
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Calf tenderness, suggesting deep vein thrombophlebitis
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If a specific source is identified, treatment specific for that source can be employed.
However, in many situations, there is considerable risk of multiple sources and
vigorous antibiotic therapy is generally initiated. Good choices for such therapy include:
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