A 35 year old, sexually active woman presents with fever and right upper abdominal pain for 3 days, and pelvic pain for a week. She also vomited twice, just prior to admission. The abdominal pain was sharp and exacerbated by inspiration and movement.
Her last menstrual period was 2 weeks ago. Her medical history is unremarkable.
Her full blood count shows only a leukocytosis of 12,000/mm3, 80% neutrophils.