Chlamydia trachomatis and the fitz-hugh-curtis syndrome

Right upper abdominal pain in the presence of pelvic inflammatory disease is called Fitz-Hugh-Curtis syndrome. It is due to perihepatitis secondary to transperitoneal spread of Neisseria gonorrhoeae or Chlamydia trachomatis. Twenty-five percent of all patients present with right upper abdominal pain as their sole complaint. In order to recognize and manage Fitz-Hugh-Curtis syndrome, the clinician must carefully consider that young, sexually active women may have occult pelvic inflammatory disease. A case history demonstrates how clinical recognition allows effective management before the results of laboratory investigations are available. The Fitz-Hugh-Curtis syndrome is readily treated with conventional antibiotic regimens.