A 24-year-old woman arrives with fever and pelvic pain 3 days after an unsafe abortion. Triage acuity is ESI 1; T 103.5 F, BP 84/46 mm Hg, HR

Question

A 24-year-old woman arrives with fever and pelvic pain 3 days after an unsafe abortion. Triage acuity is ESI 1; T 103.5 F, BP 84/46 mm Hg, HR 146/min. She has foul vaginal discharge, uterine tenderness, and guarding. Lactate is 5.0 mmol/L. Which of the following is the most appropriate disposition?

Accepted Answer

Admit for broad-spectrum IV antibiotics, resuscitation, and urgent uterine evacuation or operative source control

Answer

Observe without antibiotics

Answer

Refer to routine outpatient gynecology

Answer

Send home for repeat pregnancy test

Answer

Discharge with oral analgesics

Septic abortion — ABEM Board MCQ

A 24-year-old woman arrives with fever and pelvic pain 3 days after an unsafe abortion. Triage acuity is ESI 1; T 103.5 F, BP 84/46 mm Hg, HR 146/min. She has foul vaginal discharge, uterine tenderness, and guarding. Lactate is 5.0 mmol/L. Which of the following is the most appropriate disposition?