A postpartum patient who had a cesarean birth is evaluated for fever and wound drainage. What is the most likely diagnosis?

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Multiple Choice

A postpartum patient who had a cesarean birth is evaluated for fever and wound drainage. What is the most likely diagnosis?

The key idea is that fever accompanied by drainage from the cesarean incision points to an infection at the surgical wound. A wound infection typically presents with localized signs around the incision—purulent drainage, redness, warmth, and tenderness—along with fever. In contrast, endometritis would manifest with uterine tenderness and foul lochia, a urinary tract infection with dysuria and urinary symptoms, and mastitis with breast pain and unilateral breast changes. Therefore, the most likely diagnosis is a wound infection. Wound care and appropriate antibiotics targeting skin flora are indicated, with deeper infection or abscess needing possible drainage.

The key idea is that fever accompanied by drainage from the cesarean incision points to an infection at the surgical wound. A wound infection typically presents with localized signs around the incision—purulent drainage, redness, warmth, and tenderness—along with fever. In contrast, endometritis would manifest with uterine tenderness and foul lochia, a urinary tract infection with dysuria and urinary symptoms, and mastitis with breast pain and unilateral breast changes. Therefore, the most likely diagnosis is a wound infection. Wound care and appropriate antibiotics targeting skin flora are indicated, with deeper infection or abscess needing possible drainage.

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