29-year-old woman, gravida 1 para 1, is evaluated due to recurrent fevers on day 5 after a cesarean delivery for arrest of descent
after a prolonged induction of labor. Gentamicin and clindamycin were administered for fever on postoperative day 1. Ampicillin was
added on postoperative day 3 as the patient continued to be intermittently febrile. Today, she has no nausea, vomiting, hemoptysis,
dyspnea, hematuria, dysuria, or diarrhea. Temperature is 39 C (102 2 F), blood pressure is 120/80 mm Hg, and pulse is 108/min.
Oxygen saturation is 96% on room air. The lungs are clear to auscultation bilaterally Breast examination shows full, slightly tender
breasts with no erythema. Abdominal examination shows mild bilateral lower quadrant tenderness to deep palpation and an incision
with serosanguineous drainage but no erythema or induration. Pelvic examination reveals a nontender uterine fund us that is below
the umbilicus. Examination of the lower extremities shows no swelling, tenderness, or erythema. Hemoglobin is 10.8 g/dl Urinalysis
is normal. CT scan of the abdomen and pelvis shows no abscess or fluid collection. Which of the following is the most likely
diagnosis in this patient?
- QA Acute pyelonephritis
- 0 B. Aspiration pneumonia
- 0 C. lncisional infection
- 0 D. Postpartum endometritis
- 0 E. Pulmonary embolism
- 0 F Septic thrombophlebitis
0 voters