Online Images in the Medical Sciences| Volume 365, ISSUE 4, e71-e72, April 2023

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Fitz-Hugh Curtis syndrome

Published:December 18, 2022DOI:
      A previously healthy, 20-year-old female patient presented to the emergency department with a two-day history of right upper quadrant (RUQ) pain. The pain worsened with deep breathing or torso movement in any direction. She noticed a malodorous, greenish vaginal discharge one month before the current presentation. She had no respiratory, gastrointestinal or urinary symptoms and reported having regular sexual intercourse with a single partner using a condom. On presentation, she was hemodynamically stable. Her body temperature was 37.5 °C, and her other vital signs were normal. Abdominal examination revealed marked tenderness of the liver. Gynecological examination revealed no cervical migratory pain. Laboratory tests demonstrated leukocytes 10,200 × 109/L (normal 3,300–8,600 × 109/L) and C-reactive protein 2.97 mg/dL (normal < 0.14 mg/dL). Liver function test results were normal, and a pregnancy test returned negative. Contrast-enhanced computed tomography (CT) demonstrated early enhancement along the hepatic surface which was consistent with Fitz-Hugh Curtis syndrome (Fig. 1). Polymerase chain reaction using an endocervical swab returned positive for Chlamydia trachomatis and negative for Neisseria gonorrhoeae, confirming the diagnosis. Tests for other sexually transmitted diseases were negative. She received oral azithromycin for 14 days and intravenous, single-dose ceftriaxone.
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