Low-Grade Fever and Night Sweats After Hysterectomy: Normal Recovery or Complication?

Low-grade fever (99–100.4°F / 37.2–38°C) and night sweats are common in the first 1–2 weeks after hysterectomy.

Physiologic Causes

• Inflammatory response: Surgical trauma → cytokine release (IL-1, IL-6, TNF-α) → hypothalamic set-point elevation.
• Atelectasis: Shallow breathing post-op → basal collapse → low-grade fever (peaks day 1–2).
• Hormonal withdrawal: If ovaries removed (BSO), abrupt estrogen drop → thermoregulatory instability → night sweats, hot flashes.
• Immune activation: Healing tissue, resorption of hematoma.

Typical Course

• Fever: peaks day 1–2, resolves by day 5–7.
• Night sweats: may persist 2–6 weeks with BSO; improve with hormone therapy if indicated.

Red Flags – Contact Surgeon Immediately

• Fever >101°F (38.3°C) or >100.4°F persisting >48h.
• Increasing abdominal pain, distension, wound erythema/drainage.
• Vaginal bleeding >heavy period or foul odor.
• Calf pain, dyspnea (DVT/PE).
• Inability to void.

Self-Care

• Hydration, incentive spirometry, early ambulation.
• Acetaminophen ± NSAID per surgeon.
• Cool bedroom, moisture-wicking pajamas, fan for night sweats.
• HRT discussion if BSO and symptomatic (if no contraindication).