Perihepatitis (Fitz-Hugh--Curtis syndrome). A review and case presentation

Perihepatitis, or Fitz-Hugh--Curtis syndrome (FHC), is a complication of pelvic inflammatory disease (PID). Although though in the past Neisseria gonorrhoeae was thought to be the only etiological agent, recent data indicate that chlamydia trachomatis can produce the syndrome. Because cervical cultures frequently fail to demonstrate the presence of C. trachomatis, the serologic microimmunofluorescence antibody test is essential to diagnosis; the antibody titer in FHC syndrome is markedly higher than in PID without FHC syndrome. The classic presenting symptom of perihepatitis is severe right upper quadrant abdominal pain. If unnecessary diagnostic and surgical procedures are to be avoided, the FHC syndrome in the sexually active young woman must be included in the differential diagnosis of abdominal pain irrespective of its location. To illustrate the diagnosis and management of the FHC syndrome caused by C. trachomatis, a case of a 16-year-old adolescent female is presented.