title: [A gynaecological cause of upper abdominal pain: Fitz-Hugh-Curtis syndrome].
abstract: A 19-year-old woman was admitted to our hospital because of unexplained pain in the right upper abdomen and fever. Her medical history noted a recent uncomplicated pregnancy and birth of a healthy child. Our differential diagnosis included pyelonephritis, pulmonary embolism, pneumonia causing pleural pain, a gastrointestinal cause, or a subphrenic abscess. A vaginal culture was taken as part of a second opinion by a gynaecologist. However, after a few days PCR on the vaginal sample was positive for Chlamydia trachomatis, indicating a case of Fitz-Hugh-Curtis syndrome. This syndrome is a complication of pelvic inflammatory disease caused by a bacterial infection, most frequently Gonococcal or Chlamydia species. The patient was treated with doxycycline and recovered quickly. As a result of ignoring a possible gynaecological cause in this patient, the time to diagnosis and treatment was delayed. Left untreated, this disease might result in infertility and in complications in the newborn. A broad differential diagnosis is therefore important.
authors.affiliation: Rijnstate Ziekenhuis, afd. Interne Geneeskunde, Arnhem.
authors.forename: Eva A M
authors.initials: EA
authors.lastname: Hesius
authors.forename: Bram
authors.initials: B
authors.lastname: Kok
authors.forename: E J M Vera
authors.initials: EJ
authors.lastname: Mattijssen
mesh_terms: D000005:Abdomen; D015746:Abdominal Pain / Q000175:diagnosis*; D002690:Chlamydia Infections / Q000175:diagnosis*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D004318:Doxycycline; D005260:Female; D005334:Fever / Q000175:diagnosis; D006069:Gonorrhea / Q000175:diagnosis; D006505:Hepatitis / Q000175:diagnosis*; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis*; D010538:Peritonitis / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D004318:Doxycycline