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Fever on the third day after a caesarean

29 yG1P1Postpartum

A rigor at 04:00, a tender abdomen, and a list of places the fever could be coming from.

  1. Day 3, 06:30Step 1

    The round

    Temperature 38.6 with a rigor at 04:00. Pulse 108, blood pressure 104/64. The wound is clean. The uterus is tender below the umbilicus. Lochia is heavier than yesterday with an offensive odour. Breasts soft. Calves soft. No urinary symptoms; the catheter came out on day 1.

    HR 108 · BP 104/64 · RR 18 · T 38.6
    Wound
    Clean, dry, no erythema
    Uterus
    Tender, 2 cm below the umbilicus, lochia offensive
    Breasts
    Soft, nipples intact
    Legs
    Soft calves, no swelling

    What is the most likely source?