Fitz-Hugh-Curtis syndrome with disseminated intra-abdominal gonorrhoea

Neisseria gonorrhoea continues to be implicated in a large proportion of sexually transmitted infections worldwide. Prompt recognition of infection is required to prevent further complications which include pelvic inflammatory disease and less commonly, perihepatitis which is known eponymously as Fitz-Hugh-Curtis syndrome. Third generation cephalosporins such as ceftriaxone remain effective in the treatment of gonococcal infection, however failure in initiation of appropriate antibiotic therapy in a timely manner can result in further disseminated disease. We describe an atypical case of Fitz-Hugh-Curtis syndrome presenting with multiple intra-abdominal gonococcal collections. Our case highlights the importance of a detailed sexual history in the evaluation of acute abdominal pain in at-risk patient demographics.