title: Right pleural effusion in Fitz-Hugh-Curtis syndrome.
abstract: Right pleural effusion was diagnosed in a 36-year-old woman with right upper quadrant pain and fever. Enhanced pelvic computed tomography performed because of irregular genital bleeding revealed the pelvic inflammatory disease. Upon further questioning, the patient confirmed that she had recently undergone therapy for Chlamydia trachomatis infection. Therefore she was given an injection of tetracycline because we suspected Fitz-Hugh-Curtis syndrome (FHCS), a pelvic inflammatory disease characterized by perihepatitis associated with chlamydial infection. A remarkable clinical response to antibiotics was noted. The right upper quadrant pain was due to perihepatitis, and the final diagnosis was FHCS. Right pleural effusion may be caused by inflammation of the diaphragm associated with perihepatitis. Once chlamydial infection reaches the subphrenic liver, conditions in the closed space between the liver and diaphragm due to inflammatory adhesion may be conductive to chlamydial proliferation. The possibility of FHCS should be considered in patients and carefully distinguished from other abdominal diseases.
authors.affiliation: Department of Pathology, Showa University Hospital, Tokyo 142-8555, Japan. tajiri@showa-university-fujigaoka. gr.jp
authors.forename: Takuma
authors.initials: T
authors.lastname: Tajiri
authors.forename: Genshu
authors.initials: G
authors.lastname: Tate
authors.forename: Takeshi
authors.initials: T
authors.lastname: Iwaku
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takeyama
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Fusama
authors.forename: Shuichi
authors.initials: S
authors.lastname: Sato
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kunimura
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Mitsuya
authors.forename: Toshio
authors.initials: T
authors.lastname: Morohoshi
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000150:complications* / Q000473:pathology; D002692:Chlamydia trachomatis; D005260:Female; D006505:Hepatitis / Q000150:complications* / Q000473:pathology; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000150:complications* / Q000473:pathology; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D013577:Syndrome