Misoprostol, a synthetic prostaglandin E1 analogue originally used for the treatment of NSAID induced peptic ulcer has been found to have a wider application in the field of obstetrics and gynaecology because of its uterotonic and cervical-maturation effects [6]. It has been recommended for the treatment and prevention of PPH by ACOG, FIGO and WHO [9,10,11]. Compared to other uterotonics, misoprostol is cheap, readily available, has a longer shelf life, stable at ambient temperature, and can be administered easily. It is a very safe drug associated with transient, mild side-effects like fever, chills, nausea, vomiting, diarrhoea and abdominal pain [6]. Collective total daily doses of 1600 µg have been tolerated with only mild gastrointestinal discomfort [6]. A study done in Ecuador in 2010 showed that there was a sharp increase in temperature within 1 h of treatment, a peak in temperature 1–2 h post-treatment, and a gradual decline in temperature over a period of 3 h. Average temperatures remained above 40.0 °C for less than 2 h, and measured below 38.0 °C approximately 6 h after receiving misoprostol. In our indexed case shivering started 20 min after administration and the temperature started rising 1 h later reaching a peak of 40.3 °C 4 h later and dropping to less than 38.0 °C 12 h later. This was consistent with results of recent studies [4, 12]. Temperature elevations associated with the use of misoprostol are compatible with the hypothalamic adjustment. Prostaglandins E2 (PGE2) have been involved in the pathophysiological mechanism of endogenous fever and identified as the major mediator for inducing fever because of its interaction with the Prostaglandin E3 (PGE3) receptor. Misoprostol-induced fever mimics the PGE2 endogenous thermoregulation patterns, changing the hypothalamic adjustment in its upper segment and stimulating temperature elevation [4]. In our patient the possibility of a postpartum infection was almost zero as our patient had no risk factor such as prolong labour, premature rupture of membranes, etc. and emergency CRP and FBC had values within normal ranges. The fever is usually treated with paracetamol, anti-inflammatory and cooling [4, 12]. In our indexed case we used paracetamol and cooling and there was a good clinical response with temperature remaining less than 38 °C after 12 h (see Fig. 1).