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A 16-year-old girl presents to the ED complaining of fever, chills, abdominal pain, and vaginal bleeding. She gives a history of unprotected sexual activity with her 17-year-old boyfriend over the past several months. Her last menstrual period was 8 weeks ago. She reports having a dilatation and curettage procedure at an unlicensed abortion clinic recently to try to abort her pregnancy. Vital signs are significant for a fever of 38.7°C (101.7°F), a heart rate of 120/min, and a blood pressure of 100/70 mm Hg. Pelvic examination reveals cervical motion tenderness, tissue in the internal os, and foul-smelling vaginal discharge. Urine β-human chorionic gonadotropin is positive.
What is the most likely diagnosis?
(A) Ectopic pregnancy
(B) Pelvic abscess
(C) Septic abortion
(D) Threatened abortion
(E) Vaginal laceration
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