Case 21 - A 25-Year-Old Woman with Intrauterine Embryonic Demise and Temperature of 39.2°C

Summary

A 25-year-old female last menstrual period approximately eight weeks ago presents to the emergency department with fever and pelvic pain. She is a recent immigrant without health insurance who sought care for a termination of pregnancy from an unknown provider. She took several pills seven days ago and had subsequent heavy bleeding and cramping. She has continued bleeding and worsening cramping. She describes subjective fever for the last 24 hours. She has not obtained pain relief with acetaminophen. She feels light-headed and has not eaten today due to nausea. She denies vomiting, diarrhea, or any urinary symptoms. She is sexually active with one partner for the last six months. Her gynecologic history is significant for one full-term vaginal delivery and a history of chlamydia. She has no significant past medical or surgical history and has no known drug allergies.