[Clinical feature of Fitz-Hugh-Curtis syndrome: analysis of 25 cases].
OBJECTIVE
Fitz-Hugh-Curtis syndrome is defined as perihepatitis associated with pelvic inflammatory disease (PID). We retrospectively analyzed clinical and laboratory manifestations as well as the therapeutic response in patients with clinically diagnosed Fitz-Hugh-Curtis syndrome.


METHODS
A cohort of 25 patients with PID and perihepatitis (as diagnosed by dynamic abdominal computed tomography (CT)) was enrolled. The prognosis, clinical manifestations, and physical examination, laboratory, and CT findings were analyzed.


RESULTS
The mean (+/-SD) age of the patients was 32(+/-8) years, and all of them were sexually active, premenopausal women, and presented with abdominal pain. Of these, 52% complained of vaginal discharge. On physical examination, right upper-quadrant tenderness was the most common finding (84%), with lower-abdominal tenderness being present in 20% of patients. On laboratory examination, erythrocyte sedimentation rate and C-reactive protein were increased in 76% and 92% of the patients, respectively. The white blood cell count was increased in 60% of them. Most patients had a normal liver function test. Using a specimen of the cervical discharge, the polymerase chain reaction to test for Chlamydia trachomatis were positive in 87% (13/15) of the patients, and Chlamydia antigen was found in 75% (9/12) of them. Dynamic abdominal CT revealed subcapsular enhancement of the liver in the arterial phase. All of the patients improved with antibiotic therapy.


CONCLUSIONS
Symptoms and physical findings suggestive of PID are not present in many patients with Fitz-Hugh-Curtis syndrome. When a premenopausal woman complains of upper abdominal pain and shows CT findings compatible with perihepatitis, examination of cervical discharge would be recommended to assess the possibility of Fitz-Hugh-Curtis syndrome.
Yang
Hyeon Woong
HW
Department of Internal Medicine, Eulji University College of Medicine, Eulji University Hospital, Daejeon, Korea.
Jung
Sung Hee
SH
Han
Hyun Young
HY
Kim
Anna
A
Lee
Yun Jung
YJ
Cha
Sang Woo
SW
Go
Hun
H
Choi
Gi Young
GY
Cho
Soung Hoon
SH
Lim
Sin Hyung
SH
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002690:Chlamydia Infections / Q000175:diagnosis / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D015331:Cohort Studies; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D006069:Gonorrhea / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006505:Hepatitis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013577:Syndrome; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents