Differential Diagnosis for a Postpartum Woman with Chills, Fever, Back Pain, Pelvic Spasms, and Passing of Clots

• Single Most Likely Diagnosis
  • Endometritis: This condition is an infection of the uterus and is a common cause of postpartum fever, chills, and pelvic pain. The passing of clots can be associated with the uterus shedding its lining as it returns to its pre-pregnancy size, a process that can be complicated by infection.
• Other Likely Diagnoses
  • Urinary Tract Infection (UTI): UTIs can cause fever, chills, back pain, and pelvic discomfort. While they might not directly cause the passing of clots, a UTI could coexist with another condition causing clot passage.
  • Pelvic Thrombophlebitis: This is a blood clot in the pelvic veins and can cause fever, pelvic pain, and sometimes chills. It's less common but should be considered in the differential diagnosis for postpartum women with these symptoms.
• Do Not Miss Diagnoses
  • Septic Pelvic Thrombophlebitis: Although rare, this condition is life-threatening and requires immediate intervention. It combines the risks of thrombophlebitis with the danger of sepsis.
  • Pulmonary Embolism: While the primary symptoms described are pelvic, a pulmonary embolism (a blood clot in the lungs) can cause sudden onset of fever, chills, and back pain, among other symptoms. It's crucial to consider this diagnosis due to its high mortality rate if untreated.
• Rare Diagnoses
  • Uterine Rupture or Dehiscence: Although more commonly associated with severe abdominal pain and potentially life-threatening bleeding, uterine rupture or dehiscence could present with some of the described symptoms, especially if there's an associated infection.
  • Ovarian Vein Thrombosis: This is a rare condition where a blood clot forms in the veins that drain the ovaries. It can cause pelvic pain, fever, and sometimes chills, but it's much less common than other conditions listed here.