Fitz-Hugh-Curtis syndrome, a rare complication of
pelvic inflammatory disease, is an
inflammation of the liver
capsule (thus called perihepatitis) and the surrounding peritoneum. It occurs extremely rarely in men and is typically characterized by a sudden onset of severe
pain in the right upper abdominal quadrant. Ultrasound examination of the liver does not reveal any morphologic changes, and liver function tests are usually normal. Computerized tomography shows the thickening of the perihepatic fat, but definitive diagnosis is only possible by direct visualization by laparoscopy or
laparotomy. We present a 33-year-old HIV-positive man with Chlamydia trachomatis
proctitis who developed severe right upper abdominal quadrant
pain. Abdominal ultrasound did not show any liver pathology, while computerized tomography revealed hepatic capsular thickening. After 21 days of
doxycycline therapy, the patient's symptoms subsided. Based on the clinical presentation and liver computerized tomography examination, the diagnosis of
proctitis and the resulting
Fitz-Hugh-Curtis syndrome was made. Although it is rarely seen in male patients, it should be a part of differential diagnosis in patients who present with right upper abdominal quadrant
pain, especially in men who have sex with other men.