not-yet-known not-yet-known not-yet-known unknown 1 Case History/ Examination A 31-year-old female, non-alcohol consumer, non-smoker, presented to the Emergency Department with complaints of high-grade fever persisting for five days. The patient had been in her usual state of health until two weeks prior, when she developed an acute onset of continuous fever, with a recorded peak temperature of 103°F, which did not resolve with the use of antipyretics. The fever was associated with chills, rigors, and mild vaginal bleeding. Notably, she had a recent history of a medical termination of pregnancy at 16 weeks of gestation using mifepristone. Following the procedure, the patient experienced continuous mild vaginal bleeding and a gradual onset of fever, chills, and rigors that were refractory to antipyretic treatment. Two days after the onset of these symptoms, she sought medical care at a local hospital, where she was diagnosed with an incomplete septic abortion. She underwent a manual evacuation of retained products of conception and was admitted for five days for intravenous antibiotic therapy, after which she was discharged. However, five days post-discharge, the patient returned to the same hospital with recurrent fever and mild vaginal bleeding, mirroring her initial symptoms. A repeat diagnosis of incomplete septic abortion was made, and she underwent a second manual evacuation. After receiving appropriate treatment, she was discharged the same day with oral antibiotics. The fever and mild vaginal bleeding persisted, leading her to present at our center. The patient’s past obstetric history is notable for two lower segment cesarean sections (LSCS). On initial examination, the patient was alert and oriented, with a Glasgow Coma Scale (GCS) score of E4V5M6. Oxygen saturation (SpO2) was 93% on room air, with normal vesicular breath sounds bilaterally and no adventitious sounds. Her respiratory rate was 24 breaths per minute, heart rate was 134 beats per minute and regular, with normal heart sounds (S1/S2) and no murmurs. Her blood pressure was recorded at 130/60 mmHg. Abdominal examination revealed a soft abdomen with mild tenderness, and bowel sounds were present. The patient was infertile. Per vaginal and per speculum examinations revealed a normal cervix and free fornices bilaterally. 1 Case History/ Examination