Fitz-Hugh-Curtis syndrome lacking typical characteristics of pelvic inflammatory disease. (22nd June 2016)

• Record Type: Journal Article
• Authors: Mitaka, Hayato; Kitazono, Hidetaka; Deshpande, Gautam A; Hiraoka, Eiji
• Is Part Of: BMJ case reports. Volume 2016
• Publication Date: 2016-06-22
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2016-215711
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A 23-year-old Japanese woman, previously a commercial sex worker, presented with a 2-day history of right upper quadrant (RUQ) abdominal pain, worse on deep inspiration. She had noticed increased vaginal discharge 2 months earlier and had developed dull, lower abdominal pain 3 weeks prior to presentation. Although pelvic examination and transvaginal ultrasonography revealed neither a tubal nor ovarian pathology, abdominal CT scan with contrast demonstrated early enhancement of the hepatic capsule, a finding pathognomonic for Fitz-Hugh-Curtis syndrome (FHCS). Cervical discharge PCR assay confirmed Chlamydia trachomatis infection. This case highlights that normal gynaecological evaluation may be insufficient to rule out FHCS, for which physicians should have a high index of suspicion when seeing any woman of reproductive age with RUQ pain.