Clinical features of Fitz-Hugh-Curtis Syndrome in the emergency department

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Authors: Je Sung You ; Min Joung Kim ; Hyun Soo Chung ; Yong Eun Chung ; Incheol Park ; Sung Phil Chung ; Seungho Kim ; Hahn Shick Lee

MeSH: Adolescent ; Adult ; Anti-Bacterial Agents/therapeutic use ; Chlamydia Infections/diagnostic imaging ; Chlamydia Infections/drug therapy ; Chlamydia Infections/microbiology ; Chlamydia Infections/pathology* ; Chlamydia trachomatis/pathogenicity ; Emergency Service, Hospital ; Female ; Hepatitis/diagnostic imaging ; Hepatitis/drug therapy ; Hepatitis/microbiology ; Hepatitis/pathology* ; Humans ; Pelvic Inflammatory Disease/diagnostic imaging ; Pelvic Inflammatory Disease/drug therapy ; Pelvic Inflammatory Disease/microbiology ; Pelvic Inflammatory Disease/pathology* ; Peritonitis/diagnostic imaging ; Peritonitis/drug therapy ; Peritonitis/microbiology ; Peritonitis/pathology* ; Reproductive Tract Infections/diagnostic imaging ; Reproductive Tract Infections/drug therapy ; Reproductive Tract Infections/microbiology ; Reproductive Tract Infections/pathology ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

Keywords: Pelvic inflammatory disease ; abdominal pain ; computed tomography

Abstract: PURPOSE: Fitz-Hugh-Curtis Syndrome (FHCS) is a clinical entity characterized by inflammation of the liver capsule associated with genital tract infection. The aim of this study is to provide physicians with clinical suggestions for diagnostic approaches based on a series of patients who were diagnosed with FHCS.

MATERIALS AND METHODS: We conducted a retrospective study of patients who were diagnosed with FHCS after presenting to the emergency department (ED). The symptoms, physical examinations, laboratory findings, radiological findings, and progress of the patients were reviewed.

RESULTS: During the four-year study period, a total of 82 female patients received a final diagnosis of FHCS in the ED. Chlamydia trachomatis was identified as a pathogen in 89% of the patients. Their clinical characteristics and laboratory findings were described. Fifty-two patients (63.4%) were admitted to the hospital. All of the admitted patients improved after treatment combining antibiotic therapy with conservative care.

CONCLUSION: FHCS should be considered as a differential diagnosis for female patients of childbearing age with right upper abdominal pain. Timely diagnosis using biphasic computed tomography (CT) with arterial and portal phases may help ensure adequate medical treatment as well as avoid invasive procedures.