Chlamydia ascites: a call for sexually transmitted infection testing

Area of Science:

• Gynecology
• Infectious Diseases
• Abdominal Imaging

Background:

• Postpartum ascites is a rare condition.
• Pelvic inflammatory disease (PID) can present with ascites.

Observation:

• A 26-year-old woman presented with abdominal swelling and discomfort 10 weeks postpartum.
• Imaging revealed moderate ascites and peritoneal enhancement.
• Ascitic fluid analysis showed lymphocytic predominance and positive Chlamydia trachomatis.

Findings:

• Chlamydia trachomatis was identified in urine, cervical swab, and ascitic fluid.
• The patient was diagnosed with pelvic inflammatory disease (PID) causing exudative ascites.
• Laparoscopic cholecystectomy was performed 6 weeks prior to admission.

Implications:

• This case highlights Chlamydia trachomatis as a potential cause of postpartum ascites.
• Early diagnosis and antibiotic treatment are crucial for managing PID-related ascites.
• Successful management with doxycycline led to symptom resolution and absence of recurrence.