title: Nontuberculous mycobacterial infection in a clinical presentation of Fitz-Hugh-Curtis syndrome: a case report with multigene diagnostic approach.
abstract: BACKGROUND
  Fitz-Hugh-Curtis syndrome (FHCS) is caused by inflammation of perihepatic capsules associated with pelvic inflammatory disease. In recent years, infections with nontuberculous mycobacteria (NTM) have been increasingly occurring in immunocompromised and immunocompetent patients. However, NTM has never been reported in patients with FHCS. We present the first case of a patient with extrapulmonary NTM infection in a clinical presentation of FHCS.
  
  
  METHODS
  A 26-year-old Korean woman presented with right upper quadrant and suprapubic pain. She was initially suspected to have FHCS. However, she was refractory to conventional antibiotic therapy. Laparoscopy revealed multiple violin-string adhesions of the parietal peritoneum to the liver and miliary-like nodules on the peritoneal surfaces. Diagnosis of NTM was confirmed by the polymerase chain reaction analysis results of biopsy specimens that showed caseating granulomas with positive acid-fast bacilli. Treatment with anti-NTM medications was initiated, and the patient's symptoms were considerably ameliorated.
  
  
  CONCLUSIONS
  An awareness of NTM as potential pathogens, even in previously healthy adults, and efforts to exclude other confounding diseases are important to establish the diagnosis of NTM disease. NTM infection can cause various clinical manifestations, which in the present case, overlapped with the symptoms of perihepatic inflammation seen in FHCS.
authors.forename: Hang-Yong
authors.initials: HY
authors.lastname: Jang
authors.forename: Peter D
authors.initials: PD
authors.lastname: Burbelo
authors.forename: Yang-Seok
authors.initials: YS
authors.lastname: Chae
authors.forename: Tak
authors.initials: T
authors.lastname: Kim
authors.forename: Yunjung
authors.initials: Y
authors.lastname: Cho
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul 136-705, South Korea. cyberpelvis@gmail.com.
authors.forename: Hyun-Tae
authors.initials: HT
authors.lastname: Park
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis*; D004269:DNA, Bacterial / Q000032:analysis*; D005260:Female; D006505:Hepatitis / Q000175:diagnosis*; D006801:Humans; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis*; D009170:Nontuberculous Mycobacteria / Q000235:genetics*; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis*; D010538:Peritonitis / Q000175:diagnosis*; D016133:Polymerase Chain Reaction
chemical_list: D004269:DNA, Bacterial