Differential Diagnosis for a 22-year-old Female with Fever, Myalgia, and Products of Incomplete Abortion Leading to Death
- Single most likely diagnosis:
- Sepsis due to incomplete abortion: This is the most likely diagnosis given the presentation of fever, myalgia, and products of conception indicating an incomplete abortion. The procedure of dilation and curettage (D&C) was performed, which is standard for managing incomplete abortion. However, the patient's death suggests that sepsis, a severe and potentially life-threatening complication, could have developed.
- Other Likely diagnoses:
- Hemorrhagic shock: Although less directly implied by the symptoms described, hemorrhage is a significant risk in the context of abortion and could lead to shock, which is life-threatening.
- Amniotic fluid embolism: This is a rare but serious condition that can occur during pregnancy or shortly after delivery or abortion, where amniotic fluid enters the bloodstream and triggers a severe reaction.
- Disseminated intravascular coagulation (DIC): This condition can be triggered by sepsis, hemorrhage, or amniotic fluid embolism and leads to both widespread clotting and bleeding, which can be fatal.
- Do Not Miss diagnoses:
- Eclampsia: Although less common in the context provided, eclampsia (seizures in a pregnant woman that are not caused by pre-existing brain disorders) can occur and is life-threatening.
- Uterine perforation: A potential complication of D&C, especially if the uterus is perforated during the procedure, leading to peritonitis or hemorrhage.
- Air embolism: Another potential complication of D&C or the abortion process itself, where air enters the venous system and can lead to a blockage of blood flow.
- Rare diagnoses:
- Malignant hyperthermia: A rare but life-threatening medical emergency that can be triggered by certain medications used in general anesthesia, which might have been used during the D&C.
- Toxic shock syndrome: Although more commonly associated with tampon use, it could theoretically occur in the context of an abortion, especially if there was retained tissue or infection.