Step 2

Infectious Disease 6

A 23-year-old woman presents to the emergency department for evaluation of fever, lethargy, abdominal pain, and myalgias which developed over the past 24 hours. Vital signs are significant for a temperature of 102.1°F (38.9°C), blood pressure of 80/60 mmHg, and heart rate of 120 beats/min. Physical examination reveals warm, moist skin, a diffuse, macular erythematous rash, and a saturated tampon in the vaginal canal. Intravenous fluids are started, the tampon is removed, and blood cultures are sent.

Which of the following regimens is most appropriate to initiate?

  • A) Cefazolin and clindamycin
  • B) Supportive care until cultures return
  • C) Vancomycin alone
  • D) Vancomycin and clindamycin
  • E) Vancomycin, clindamycin, and cefepime


Alexandra Conway


Dr. Ted O'Connell