A CASE OF FITZ-HUGH CURTIS SYNDROME DUE TO CHLAMYDIA INFECTION

Abstract

A 33-year-old woman was seen at the hospital because of right hypochondralgia on September 2, 1991. On blood biochemical examination, the WBC count was 10, 200/mm3 and CRP was 4+, but no findings directly indicative of a diagnosis were obtained by ultrasound, CT, or gastroendoscopic examination. The patient developed an acute pain in the abdomen after endoscopy on September 4 and was admitted to the hospital. On September 8, genital bleeding was noted, and examination at the department of Obstetic and Gynecology disclosed right adenexitis due to Chlamydia infection. The antibiotic was changed to M1N0, and conservative therapy was sustained. However, right back pain and symptoms of peritonitis appeared, and imaging examination revealed intrapelvic abscesses and right hydronephrosis. Open abdominal drainage was carried out on September 13. The patient was diagnosed as Fitz-Hugh Curtis syndrome, because of anti-Chlamydia antibody level of 128 times, fibrous adhesion between the liver and the surrounding tissues, and the presence of right adenexitis. In this case, early diagnosis and administration of effective antibiotics are considered to have been needed. Fitz-Hugh Curtis syndrome should be included as a differential diagnosis of celiopathy in women complaining of right upper abdominal pain.