Clinical feature of Fitz-Hugh-Curtis syndrome: Analysis of 25 cases.
10.3350/kjhep.2008.14.2.178
- Author:
Hyeon Woong YANG
1
;
Sung Hee JUNG
;
Hyun Young HAN
;
Anna KIM
;
Yun Jung LEE
;
Sang Woo CHA
;
Hun GO
;
Gi Young CHOI
;
Soung Hoon CHO
;
Sin Hyung LIM
Author Information
1. Department of Internal Medicine, Eulji University College of Medicine, Eulji University Hospital, Daejeon, Korea. jsh@eulji.ac.kr
- Publication Type:Original Article ; English Abstract
- Keywords:
Fitz-Hugh-Curtis syndrome;
Perihepatitis;
Pelvic inflammatory disease;
Chlamydia trachomatis
- MeSH:
Adult;
Anti-Bacterial Agents/therapeutic use;
Chlamydia Infections/diagnosis/microbiology;
Chlamydia trachomatis/isolation & purification;
Cohort Studies;
Diagnosis, Differential;
Drug Therapy, Combination;
Female;
Gonorrhea/complications/*diagnosis/radiography;
Hepatitis/complications/*diagnosis/radiography;
Humans;
Pelvic Inflammatory Disease/complications/*diagnosis/radiography;
Retrospective Studies;
Syndrome;
Tomography, X-Ray Computed
- From:The Korean Journal of Hepatology
2008;14(2):178-184
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: 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.