This patient is most likely suffering from an infection

A 19-year-old sexually active female presents with a chief complaint of severe, stabbing lower abdominal pain. She also complains of foul-smelling vaginal discharge and pain with sex. On physical examination, she does not have a fever and complains of both abdominal and adnexal pain. Pelvic examination is difficult to perform secondary to pain, but her cervix appears erythematous with mucopurulent discharge coming from the os. When the bed upon which the patient is lying is jarred, she screams in pain. This patient is most likely suffering from an infection that originated in which of the following structures?

Bladder
Cervix
Fallopian tubes
Ovaries
Rectum

Correct answer
Cervix
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correct answer: B

This patient fits the clinical picture of acute salpingitis, or pelvic inflammatory disease (PID), the most common serious complication of sexually transmitted infections. PID generally begins as cervicitis (Choice B) caused by Neisseria gonorrhoeae and/or Chlamydia trachomatis. If untreated, the infection can ascend to the upper reproductive tract (Choice C and D). Although the definitive diagnosis is made by laparascopy revealing pyosalpinx, the diagnosis of PID is made clinically with an elevated white blood cell count, fever, pelvic pain, cervical motion tenderness, and adnexal tenderness. The original infection most likely did not originate from either the bladder (Choice A) or rectum (Choice E).