ABSTRACT
A multitude of causes exist for the occurrence of high-grade fever in a post operative patient, with psychosomatic origin of fever being extremely rare and hence naturally posing unique diagnostic challenges.
After a radical moiety nephrectomy for a malignant renal mass in a horseshoe kidney, a 32-year-old male patient underwent exploratory laparotomy to treat a fecal fistula caused by ischemic colonic injury during the primary surgery.
During the postoperative period, the patient developed a high-grade fever with no known cause. Evaluation for all possible organic causes of fever turned negative and a diagnosis of psychogenic fever was considered in light of the patient’s concomitant low mental state. Initiation of naproxen with adequate psychoeducation about the disease status and prognosis resulted in fever cessation. We aim to depict the clinical scenario with discussion on psychogenic fever, its pathogenesis and management options.

IMPACT STATEMENT
Psychogenic fever is a less understood entity that is often overlooked during fever evaluation because of its less understood mechanisms. Fever of psychosomatic origin must be considered in patients experiencing long term intensive care, going through cancer management, or in anyone with accompanying psychiatric or psychological issues.
There is a lack of understanding regarding the pathogenesis, with attribution to multiple factors for its origin. This article explains the pathophysiology of this unusual clinical situation with a brief account on the role of naproxen in its diagnosis and management.