Review Question - QID 213635

A 25-year-old woman presents to the emergency room with complaints of pelvic pain for the past 3 days. She describes an 8/10, constant, dull pain that is minimally responsive to over-the-counter pain medicine. She has never been pregnant and has regular periods every 28 days with moderate flow. She is sexually active and uses oral contraceptives. Her last sexual encounter was last week. She denies any other gynecologic history including STIs though she does endorse an increase in discharge over the past several days. A pelvic examination demonstrates cervical motion tenderness and the cervical finding shown in Figure A. Progression of this patient’s disease can lead to which of the following presentations?