A 28-year-old female presents with toxic appearance and cervical motion tenderness. What is the next best step in her evaluation?

In the scenario described, the patient exhibits a toxic appearance and cervical motion tenderness, which are indicative of a possible serious infection, such as pelvic inflammatory disease (PID) or another reproductive tract infection. In such cases, obtaining an endocervical culture is essential as it helps identify the specific pathogens responsible for the infection. Cultures are important for guiding appropriate antibiotic therapy, particularly in cases where there is a suspicion of sexually transmitted infections, such as Neisseria gonorrhoeae or Chlamydia trachomatis.

Additionally, endocervical cultures allow for further evaluation of the cervical and vaginal flora, which may help determine the extent and nature of the infection. Prompt identification and treatment are critical to preventing complications, such as abscess formation or chronic pelvic pain.

The other options do not provide the immediate necessary data to manage the suspected infection effectively. Abdominal x-ray does not help specifically in evaluating reproductive tract infections. Laparoscopy is a more invasive procedure typically reserved for cases where there is a need to directly visualize and potentially treat underlying pathology, which may not be necessary at this stage. Hysterosalpingogram is used primarily for assessing the patency of the fallopian tubes and is not suited for diagnosing acute infections. Thus