Fitz-Hugh-Curtis Syndrome: A Diagnosis to Consider in a Woman with Right Upper Quadrant Abdominal Pain without Gallstones
  • Pietro Benedetto Faré
    Internal Medicine Department, Ospedale La Carità, Locarno, Switzerland
  • Ileana Allio
    Internal Medicine Department, Ospedale La Carità, Locarno, Switzerland
  • Rita Monotti
    Internal Medicine Department, Ospedale La Carità, Locarno, Switzerland
  • Fabrizio Foieni
    Internal Medicine Department, Ospedale La Carità, Locarno, Switzerland

Abstract

A young woman presented with right upper quadrant abdominal pain exacerbated by movement and breathing. Extensive evaluation revealed no gallstones or any other specific cause. Urine polymerase chain reaction results for Chlamydia trachomatis were positive, so the clinical diagnosis of Fitz-Hugh-Curtis syndrome was confirmed. This type of localized peritonitis is thought to be a complication of an ascending genital infection leading to pelvic inflammatory disease. The diagnosis is established on clinical grounds after excluding alternative, more common conditions. Proper antibiotic treatment usually leads to recovery and prevents long-term complications.

VIEW THE ENTIRE ARTICLE

References

  • Singer AJ et al. Correlation among clinical, laboratory, and hepatobiliary scanning findings in patients with suspected acute cholecystitis. Ann Emerg Med. 1996;28:267.
  • Nadia JP et al. Fitz-Hugh-Curtis syndrome: A diagnosis to consider in women with right upper quadrant pain. CCJM 2004;71:233-239.
  • Stajano C. La reaccion frenica en ginecologica. Semana Medica-Beunoa Airea 1920; 27:243–248.
  • Fitz-Hugh T Jr. Acute gonococcic peritonitis of the right upper quadrant in women. JAMA 1934; 102:2094–2096.
  • Curtis A. A cause of adhesions in the right upper quadrant. JAMA 1930; 94:1221–1222.
  • Muller-Schoop JW, Wang SP, Munzinger J, et al. Chlamydia trachomatis as possible cause of peritonitis and perihepatitis in young women. Br Med J 1978; 1:1022–1024
  • Paavonen J, Saikku P, von Knorring J, Aho K, Wang SP. Association of infection with Chlamydia trachomatis with Fitz-Hugh-Curtis syndrome. J Infect Dis 1981; 144:176.
  • Ris HW. Perihepatitis (Fitz-Hugh-Curtis syndrome). A review and case presentation. J Adolesc Health Care 1984; 5:272–276.
  • McCormack WM. Pelvic inflammatory disease. N Engl J Med 1994;330:115–119.
  • Romo LV, Clarke PD. Fitz-Hugh-Curtis syndrome: pelvic inflammatory disease with an unusual CT presentation. J Comput Assist Tomogr 1992; 16:832–833.
  • van Dongen PW. Diagnosis of Fitz-Hugh-Curtis syndrome by ultrasound. Eur J Obstet Gynecol Reprod Biol 1993; 50:159–162.
  • Schoenfeld A, Fisch B, Cohen M, Vardy M, Ovadia J. Ultrasound findings in perihepatitis associated with pelvic inflammatory disease. J Clin Ultrasound 1992; 20:339–342.
  • Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2002. MMWR Recomm Rep 2002; 51:1–78.
  • Ford GW et al. Pelvic Inflammatory Disease. Dis Mon 2016; 62:301–305
  • Lane AB, Decker CF. Chlamydia Trachomatis Infections. Dis Mon 2016; 62:269–273.
  • Workowski KA, Berman SM, Douglas JM Jr. Emerging antimicrobial resistance in Neisseria gonorrhoeae: urgent need to strengthen prevention strategies. Ann Intern Med. 2008;148:606-613.
  • Centers for Disease Control and Prevention. Recommendations for the Laboratory-Based Detection of Chlamydia trachomatis and Neisseria gonorrhoeae 2014. MMWR Recomm Rep 2014; 63:1–21.
  • Katzman DK, Friedman IM, McDonald CA, Litt IF. Chlamydia trachomatis Fitz-Hugh-Curtis syndrome without salpingitis in female adolescents. Am J Dis Child 1988; 142:996–998.
  • Views: 3016
    HTML downloads: 1974
    PDF downloads: 815


    Published: 2017-12-05
    Issue: Vol. 5 No. 2 (view)


    How to cite:
    1.
    Faré PB, Allio I, Monotti R, Foieni F. Fitz-Hugh-Curtis Syndrome: A Diagnosis to Consider in a Woman with Right Upper Quadrant Abdominal Pain without Gallstones. EJCRIM 2017;5 doi:10.12890/2017_000743.