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Review Question - QID 103372

Postpartum Endometritis Presentation Symptoms QID: 103372 (M2.OB.13.9)
In scope icon M 7 E
QID 103372 (Type "103372" in App Search)
A 25-year-old woman is evaluated on the postpartum floor for abdominal pain. She underwent delivery via cesarean section 2 days prior due to second-stage arrest of labor. She noticed lower abdominal pain when she woke up this morning, and has had subjective fever and chills since last night. Her temperature is 102.2°F (39.0°C), blood pressure is 120/70 mmHg, pulse is 103/min, respirations are 20/min, and oxygen saturation is 99% on room air. On physical exam, she has no flank tenderness, but does have tenderness to palpation at the level of the uterine fundus. Pelvic exam is notable for purulent, foul-smelling discharge. A chest radiograph is obtained as shown in Figure A. Laboratory studies are obtained as shown below.

Blood:
Hemoglobin 12.0 g/dL
Hematocrit: 37%
Leukocyte count: 14,000/mm^3
Platelet count: 200,000


Urine
Protein: 1+
Glucose: trace
RBC: 0/hpf
WBC: 0/hpf
Leukocyte esterase: negative
Nitrites: negative

Which of the following is the most likely diagnosis?
  • A
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  • A