This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: All India exam, Subject name: Gynaecology & Obstetrics
A 17-year-old unmarried girl presents with fever, nausea, vomiting, pallor and pain abdomen. She is having foul smelling blood stained discharge per vaginum. Your most likely diagnosis of this case is 
Select and explain. 
A. Twisted ovarian cyst, B. Typhoid with enteric perforation, C. Pelvic abscess with septic peritonitis, D. Ruptured ectopic pregnancy
C: Pelvic abscess with septic peritonitis
Answer: C: Pelvic abscess with septic peritonitis 
Explanation: It is a case of septic aboion complicated by septic peritonitis and pelvic abscess. As the patient is unmarried she had some procedure as criminal aboion to terminate unwanted pregnancy. In case of twisted ovarian cyst, fever and vaginal discharge are absent. In ruptured ectopic pregnancy, same findings are there but fever is usually absent and vaginal discharge is not foul smelling, there is only slight bleeding