Fitz-Hugh-Curtis syndrome; Gonococcal/Chlamydia perihepatitis

Etiology

• complication of pelvic inflammatory disease
  • Chlamydia trachomatis
  • Neisseria gonorrhoeae

Epidemiology

• rare
• occurs almost exclusively in women

Pathology

• peritonitis
• perihepatitis

Clinical manifestations

• fever, chills, headaches, malaise
• right upper quadrant abdominal pain
• pelvic adnexal tenderness

Laboratory

• complete blood count (CBC): leukocytosis
• Chlamydia trachomatis DNA
• Neisseria gonorrhoeae DNA
• liver function tests generally unchanged from baseline

Diagnostic procedures

• cervical smear showing Neisseria gonorrhoeae

Radiology

• abdominal ultrasound generally normal

Complications

• abdominal adhesions

Management

• treat underlying infection
  • ceftriaxone plus azithromycin
  • doxycycline, oflaxacin, metronidazole
• laparoscopy for lysis of adhesions

More general terms

• syndrome