Fitz-Hugh Curtis syndrome (FHCS) is a rare sequela of
pelvic inflammatory disease that must be included on the differential in patients with
abdominal pain, particularly if they have risk factors for
sexually transmitted infections. In this case, a 25-year-old female with a past history of Chlamydia presented to the emergency department with
vaginal discharge and right upper quadrant
pain. Complete blood count showed a mild
leukocytosis, and computed tomography demonstrated fat stranding inferior to the liver and along the right colon. The patient was diagnosed with
Fitz-Hugh Curtis syndrome and admitted for intravenous (IV)
antibiotics. After 48 hours of IV
antibiotics she was discharged with a 14-day course of
doxycycline and
metronidazole. Multiple bacterial species have been implicated in FHCS, including but not limited to Chlamydia trachomatis, Neisseria gonorrheae, Mycoplasma genitalium, Peptostreptococcus spp., and Prevotella spp. Therefore, careful consideration should be given to the choice of antimicrobial treatment.
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