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Polly is a 16-year-old girl with no significant medical history who presents to the emergency department (ED) with fever, lower abdominal pain, and vomiting. In the ED, ultrasonography of the right lower quadrant (RLQ) shows a normal-appearing appendix, and a pelvic ultrasound with Doppler is normal. Polly is given a 1-L intravenous (IV) bolus of normal (0.9%) saline and oral ondansetron, but she vomits during an oral challenge. A urinalysis and urine culture have been ordered, but these results are still pending. The physician caring for her in the ED calls you with a request for admission, and you begin your patient evaluation.

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