A sexually active young woman presents with lower abdominal pain, fever, foul-smelling discharge, and pain with intercourse. This presentation is most consistent with which condition?

• A. UTI
• B. Ectopic pregnancy
• C. Pelvic inflammatory disease
• D. Dysmenorrhea

Answer: (C)

This set of findings points to an infection of the upper female genital tract that has risen from the cervix—the pelvic inflammatory disease process. The combination of lower abdominal pain, fever, foul-smelling discharge, and pain with intercourse is classic for PID, which often stems from sexually transmitted infections such as gonorrhea or chlamydia. The fever and malodorous discharge reflect active infection and inflammation of the pelvic organs, and pain with intercourse is common when the uterus, fallopian tubes, or surrounding tissues are inflamed.

Understanding how this differs from the other options helps solidify the diagnosis: a urinary tract infection typically causes dysuria, frequency, and suprapubic tenderness without foul vaginal discharge; an ectopic pregnancy would usually involve a positive pregnancy test with unilateral pain and possible signs of internal bleeding; dysmenorrhea is menstrual cramping without fever or vaginal discharge.