[Two cases of Fitz-Hugh-Curtis syndrome in acute phase]

Fitz-Hugh-Curtis syndrome has been defined as perihepatitis accompanying pelvic inflammatory disease caused by Neisseria gonorrhoeae and Chlamydia trachomatis. In the acute phase, patients usually complain of severe right upper quadrant pain of sudden onset. The pain is sharp, pleuritic and most intense at the level of the right lower rib margin and thus it is frequently confused with acute cholecystitis or pleurisy. Definitive diagnosis of Fitz-Hugh-Curtis syndrome needs invasive procedures such as laparoscopy or laparotomy, but considering that Fitz-Hugh-Curtis syndrome is a benign condition that can be cured by oral administration of appropriate antibiotics, noninvasive diagnosis is desirable. Recently, we have experienced two cases of Fitz-Hugh-Curtis syndrome in acute phase accompanied with sharp and pleuritic right upper quadrant pain. In one case, pelvic inflammatory disease was not definite, so at first we mistook it for acute cholecystitis and reactivation of chronic hepatitis B. In the other case, Fitz-Hugh-Curtis syndrome followed the preceding, typical pelvic inflammatory disease. Both cases were diagnosed noninvasively and treated successfully by oral administration of antibiotics.