Following a vaginal delivery, a woman develops a fever, lower abdominal pain, and uterine tenderness. She is alert, and her blood pressure and urine output are good. Large gram-positive rods suggestive of clostridia are seen in a smear of the cervix. Which of the following is most closely tied to a decision to proceed with hysterectomy?
a. Close observation for renal failure or hemolysis
b. Immediate radiographic examination for hydrosalpinx
c. High-dose antibiotic therapy
d. Fever of 103°C
e. Gas gangrene