Clinical Pearls

The most common cause of fever after cesarean delivery is endomyometritis.

The major organisms responsible for postcesarean endomyometritis are anaerobic bacteria.

Atelectasis is rare in obstetric patients as a large number of women have regional anesthesia.

REFERENCES

Cunningham FG. Leveno KJ. Bloom SL. Hauth JC. Gilstrap LC III. Wenstrom KD. Puerperal infection. In: Williams obstetrics, 22nd ed. New York: McGraw-Hill. 2005:711-724.

Hayashi RH. Gambone JC. Obstetrical hemorrhage and puerperal sepsis. In: Hacker NF, Moore JG, Gambone JC. eds. Essentials of obstetrics and gynecology, 4th ed. Philadelphia: Saunders. 2004:146-156.

A 31-year-old woman comes in for a well-woman examination. Her last menstrual period was 2 weeks ago. She has no significant past medical or surgical history. She denies having been treated for sexually transmitted diseases. On examination, her blood pressure is 130/70. heart rate 70 bpm, and she is afebrile. Her thyroid is normal on palpation. Heart and lung examinations are within normal limits. The abdomen is nontender and without masses. Examination of the external genitalia reveals a nontender, firm, ulcerated lesion approximately 1 cm in diameter, with raised borders and an indurated base. Bilateral inguinal lymph nodes that are nontender are noted. Her pregnancy test is negative.

^ What is the most likely diagnosis?

♦ What is your next step in diagnosis?

^ What is the best therapy for this condition?

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