Fever after a cardiac operation is commonly caused by myocardial infar
ction, postpericardiotomy syn drome, post-myocardial infarction syndro
me (Dressier's syndrome), or postperfusion syndrome resulting from cyt
omegalovirus infection. Postpericardiotomy syndrome and post-myocardia
l infarction syndrome are autoimmune disorders characterized by eosino
philia, pleuritic chest pain, and pleural effusions. In contrast, the
diagnosis of postperfusion syndrome caused by cytomegalovirus is sugge
sted if the patient has a mild sore throat, no pleural component or ch
est pain, no eosinophilia, and atypical lymphocytosis. The syndromes o
f injury after cardiac surgical procedures are diagnoses of exclusion,
but the diagnosis of postperfusion syndrome (''40-day postoperative f
ever'') may be made on the basis of elevated cytomegalovirus IgM titer
s.