Presentation
We present a case of Fitz-Hugh Curtis syndrome associated with tuberculous salpingitis and peritonitis, presenting with new onset ascites. [bmcgastroenterol.biomedcentral.com]
An unusual presentation of Fitz-Hugh-Curtis syndrome. J Emerg Med 1994;12:167–170. 12. Lee SC, Nah BG, Kim HS, et al. Two cases of Fitz-Hugh-Curtis syndrome in acute phase. Korean J Gastroenterol 2005;45:137–142. 13. [synapse.koreamed.org]
The patient did not have risk factors for invasive S. aureus.5 The clinical presentations of S. aureus have been thoroughly investigated through time, and perihepatitis is not among the common presentations. [journals.lww.com]
We present a case of Fitz-Hugh-Curtis syndrome with a young female who presents with a complaint of right upper quadrant abdominal pain for 2 months’ duration. She initially had no genitourinary complaints. [hindawi.com]
Of the annual mean number of patients admitted to the emergency ward with suspicion of acute cholecystitis within the same three year period, 2.6% presented with gonococcal perihepatitis. [ncbi.nlm.nih.gov]
Entire Body System
- Fever
She noticed a low-grade fever (a temperature of 37.5°C per mouth was noted on admission). Physical examination was significant for abdominal tenderness localized to the right upper quadrant with a negative Murphy sign. [amjmed.com]
547 Fever and ao'ue 551 Fever-blisters 77, 610 Figwarts 389,608 First sound of the heart 204 Fish-skin - 607 Fissures on the tongue 103 Fistulse ani 267 Fistula denlalis 83 Fistula thoracica 197 Flatulency 293 Flores sulphuris 275 Fontanelles 29 Form [ebooksread.com]
He referred satiety and abdominal pain without weight loss fever, nausea and vomiting. Vital signs were within normal limits. Laboratories showed a haemoglobin of 14g/dl, white blood cells (WBC) 8.5x103/ul, platelets 130x103/ul. [panafrican-med-journal.com]
[…] initially affects the pelvic region and later spreads to upper abdomen region, affecting the liver The characteristic feature of this disorder is a painfully inflamed liver, causing an intense pain in the upper right abdomen portion, accompanied by fever [dovemed.com]
Fever with abdominal pain, pelvic pain, and vaginal discharge can be symptoms of this disease. Men: Fever, discharge from the penis, and painful urination may signal an infection, especially involving inflammation of the testicles. [emedicinehealth.com]
- Chills
There may possibly be nausea, vomiting, hiccups, chills, fever, night sweats, headaches, and general malaise. There are often features of acute salpingitis but this is not invariable. [medigoo.com]
Common symptoms include severe pain in the upper right quadrant of the abdomen, fever, chills, headaches, and a general feeling of poor health (malaise). [speciality.medicaldialogues.in]
Other symptoms might include: Fever Chills Night sweat Nausea and vomiting Hiccups Headaches A general feeling of poor health (malaise) The symptoms of PID -- pain in the lower belly and vaginal discharge -- are often present, as well. [webmd.com]
[…] with Fitz-Hugh-Curtis: Sudden onset of severe pain in the upper right part of the abdomen, over the gallbladder Pain that may have moved to the right shoulder and inside of right arm Increasing pain with coughing, sneezing, or movement Nausea Vomiting Chills [verywell.com]
- Unsafe Sexual Practices
[…] partners, avoiding unsafe sexual practices, and routinely using appropriate barrier protection. [emedicine.medscape.com]
- Acute Onset of Symptoms
Pathophysiology Gonococcal infections tend to be associated with the acute onset of symptoms and purulent mucosal drainage due to the organism's ability to recruit polymorphonuclear leukocytes (PMNs). [pedsinreview.aappublications.org]
Gastrointestinal
- Abdominal Pain
Constipation is a most common cause of abdominal pain in children. However, FHCS should be considered in a potentially sexually active girl with an accompanied right upper quadrant abdominal pain. [gynecology-obstetrics.imedpub.com]
This syndrome usually presents with right upper quadrant (RUQ) abdominal pain together with lower abdominal pain and vaginal discharge. [elsevier.es]
Similar cases of right upper quadrant abdominal pain were described by Fitz-Hugh, Jr. in 1934. A 40-year-old Caucasian male presented with a progressively abdominal right quadrant pain and left side quadrant pain. [panafrican-med-journal.com]
RESULTS All of the patients visited our hospital for pain in the right upper abdominal quadrant on the first visit, with lower abdominal pain in six patients (31.6%) and right-sided pain in two (10.5%). [ncbi.nlm.nih.gov]
- Right Upper Quadrant Pain
There was no abnormality noted in the right upper quadrant. The patient received additional pain medication and antibiotics. [patientcareonline.com]
She presented with pain in the right upper quadrant associated with fever and neutrophilic leukocytosis. She was a light smoker, nulliparous, and sexually active. [scielo.br]
In the acute phase presents pain of pleuritic characteristics in right upper quadrant (1,2). [scielo.isciii.es]
[…] in the right upper quadrant. [panafrican-med-journal.com]
RESULTS All of the patients visited our hospital for pain in the right upper abdominal quadrant on the first visit, with lower abdominal pain in six patients (31.6%) and right-sided pain in two (10.5%). [ncbi.nlm.nih.gov]
- Nausea
He referred satiety and abdominal pain without weight loss fever, nausea and vomiting. Vital signs were within normal limits. Laboratories showed a haemoglobin of 14g/dl, white blood cells (WBC) 8.5x103/ul, platelets 130x103/ul. [panafrican-med-journal.com]
[…] the pelvic region and later spreads to upper abdomen region, affecting the liver The characteristic feature of this disorder is a painfully inflamed liver, causing an intense pain in the upper right abdomen portion, accompanied by fever, vomiting, and nausea [dovemed.com]
Other symptoms might include: Fever Chills Night sweat Nausea and vomiting Hiccups Headaches A general feeling of poor health (malaise) The symptoms of PID -- pain in the lower belly and vaginal discharge -- are often present, as well. [webmd.com]
[…] symptoms associated with Fitz-Hugh-Curtis: Sudden onset of severe pain in the upper right part of the abdomen, over the gallbladder Pain that may have moved to the right shoulder and inside of right arm Increasing pain with coughing, sneezing, or movement Nausea [verywell.com]
- Lower Abdominal Pain
This syndrome usually presents with right upper quadrant (RUQ) abdominal pain together with lower abdominal pain and vaginal discharge. [elsevier.es]
FHCS is defined as perihepatitis and usually associated with PID but patients with FHCS often lack lower abdominal pain [13]. Absence of preceding lower abdominal pain does not rule out PID or FHCS. [primescholars.com]
A 14-year-old girl developed intermittent lower abdominal pain accompanied by constipation. She presented with subsequent right upper quadrant abdominal tenderness. [gynecology-obstetrics.imedpub.com]
View Full Size Symptoms of cervicitis may vary from a nonspecific vaginal discharge to more specific symptoms including intermenstrual bleeding, dysuria, lower abdominal pain, and dyspareunia. [www2a.cdc.gov]
The signs and symptoms at that time, which included severe lower abdominal pain and purulent vaginal discharge, had resolved with the completion of antibiotic treatment. [speciality.medicaldialogues.in]
- Abdominal Tenderness
Physical examination was significant for abdominal tenderness localized to the right upper quadrant with a negative Murphy sign. [amjmed.com]
A 14-year-old girl developed intermittent lower abdominal pain accompanied by constipation. She presented with subsequent right upper quadrant abdominal tenderness. [gynecology-obstetrics.imedpub.com]
She had a hysterosalpingogram that showed bilateral tubal blockage and clinical assessment showed right sided abdominal tenderness, cervical excitation tenderness, and adnexa tenderness. [njcponline.com]
Physical examination revealed RUQ abdominal tenderness and vaginal secretions, pelvic pain that was denied by the patient. [ijcasereportsandimages.com]
Examination There may be typical features of PID with lower abdominal tenderness, cervical excitation pain and tender adnexa Auscultation over the anterior costal margin may show a friction rub described as walking in new snow. [patient.info]
Cardiovascular
- Heart Murmur
Her chest was clear to auscultation bilaterally and no heart murmur or gallops were detected. Her genitourinary examination revealed that the vaginal discharge was milky white and slightly increased. [primescholars.com]
Heart murmur, skin lesions and penile discharge were not noted. [the-medical-dictionary.com]
Liver, Gall & Pancreas
- Liver Tenderness
Liver Insufficiency. Fitz-Hugh-Curtis syndrome or gonococcal perihepatitis presents as acute abdominal pain with liver tenderness on palpation and elevated liver function tests. [clinicaladvisor.com]
[…] adnexal tenderness is present. [glowm.com]
Skin
- Night Sweats
Other symptoms might include: Fever Chills Night sweat Nausea and vomiting Hiccups Headaches A general feeling of poor health (malaise) The symptoms of PID -- pain in the lower belly and vaginal discharge -- are often present, as well. [webmd.com]
sweats Headaches Hiccupping Common Causes and Diagnosis In general, a physician cannot see or feel the presence of Fitz-Hugh-Curtis syndrome, so upper abdominal pain may be the only way to suggest the direction of diagnosis. [verywell.com]
sweats Headaches Hiccupping Common Causes and Diagnosis In general, a healthcare provider cannot see or feel the presence of Fitz-Hugh-Curtis syndrome, so upper abdominal pain may be the only way to suggest the direction of diagnosis. [verywellhealth.com]
There may possibly be: Nausea Vomiting Hiccups Chills Fever Night sweats Headaches General malaise There are often features of acute salpingitis but this is not invariable. [patient.info]
Psychiatrical
- Suggestibility
Descriptive Epidemiology 587 Mechanisms and Routes of Transmission 7 Pathogenesis and Immunity 590 Patterns of Host Response 591 Control and Prevention 592 References 593 Suggested Reading 595 Rocky Mountain Spotted Fever Theodore E Woodward and J Stephen [books.google.com]
In two patients the gonococcal aetiology of the disease was suggested by papular skin lesion and arthritis. [ncbi.nlm.nih.gov]
All of this suggest Fitz-Hugh-Curtis syndrome as the origin of her acute inflammatory process, though no signs and symptoms were indicative of current or recent pelvic inflammatory disease. [amjmed.com]
Regardless, if the adhesions are not bothering you, I would be reluctant to suggest any intervention. ~ ~ ~ ~ 6.) [adhesions.org]
SMI revealed signals suggesting small vessels passing from the liver surface to the hypoechoic space. [link.springer.com]
Breast
- Agalactia
126) ESR (mm/h) 51.2 ± 28.9 (18-120) CRP (mg/L) 52.1 ± 41.9 (2-154) Positive result of number (%) Serologic test or PCR (n = 21) C. trichomatis 18 (85.7) T. vaginalis 1 (4.8) U. urealyticum 1 (4.8) M. hominis 1 (4.8) Microbiologic culture (n = 21) S. agalactiae [wjgnet.com]
Prompt broad-spectrum antibiotic treatment covering Neisseria gonorrhea, Chlamydia tracomatis, enteric gram-negative rods, Streptococcus agalactiae, Ureaplasma urealyticum, and Mycoplasma genitalium, Gardneralla vaginalis, and Haemophilus influenza, is [primescholars.com]
N gonorrhoeae and C trachomatis, [15] organisms involved in PID include the following: Mycoplasma hominis Mycoplasma genitalium [16, 17] Ureaplasma urealyticum Herpes simplex virus 2 (HSV-2) Trichomonas vaginalis Haemophilus influenzae Streptococcus agalactiae [emedicine.medscape.com]
Urogenital
- Salpingitis
The condition most commonly (but not exclusively) occurs in females with PID/salpingitis infected with Chlamydia trachomatis or Neisseria gonorrhoeae the commonly defined causative organisms. [lifeinthefastlane.com]
The condition most commonly (but not exclusively) occurs in females with pelvic inflammatory disease/salpingitis infected with Chlamydia trachomatis or Neisseria gonorrhoeae the commonly defined causative organisms. [litfl.com]
In the majority of cases it is associated with chlamydial or gonococcal salpingitis. We present a case of Fitz-Hugh Curtis syndrome associated with tuberculous salpingitis and peritonitis, presenting with new onset ascites. [bmcgastroenterol.biomedcentral.com]
The relative importance of N. gonorrhoeae in these women usually has not been simultaneously determined, but in one report infertility rates after chlamydial salpingitis (23%), gonococcal salpingitis (24%), and nonchlamydial nongonococcal salpingitis [glowm.com]
The New England journal of medicine. 1970 May 7 [PubMed PMID: 4245224] [4] Wølner-Hanssen P,Weström L,Mårdh PA, Perihepatitis and chlamydial salpingitis. [statpearls.com]
- Cervical Motion Tenderness
During a pelvic exam, uterine or adnexal tenderness and cervical motion tenderness may be noted. Evidence of cervicitis may be present as well. [www2a.cdc.gov]
Surprisingly there is often no or only minimal pelvic pain, vaginal discharge or cervical motion tenderness, which may lead to the diagnosis being missed. [en.wikipedia.org]
- Adnexal Tenderness
The most common physical exam findings are bilateral adnexal tenderness and purulent cervical discharge. Cervical motion, uterine, and lower abdominal tenderness may also be present. [cdemcurriculum.com]
During a pelvic exam, uterine or adnexal tenderness and cervical motion tenderness may be noted. Evidence of cervicitis may be present as well. [www2a.cdc.gov]
Pleuritic RUQ pain and tenderness may occur with or after the onset of acute PID. Some degree of cervicitis or adnexal tenderness is also usually present. [adhesions.org]
Suprapubic tenderness, right adnexal tenderness, minimal vaginal bleeding, and a thin malodorous vaginal discharge were noted. No adnexal masses were palpated, and no tenderness was elicited over McBurney point. [patientcareonline.com]
Cervical motion and adnexal tenderness may suggest underlying pelvic inflammatory disease.2,3 Diagnosis of this syndrome can be challenging because of its similar presentation with many hepatobiliary pathologies. [elsevier.es]
- Uterine Tenderness
uterine tenderness and adnexal tenderness. [primescholars.com]
Clinical Diagnostic Criteria for PID One or more of the following minimum criteria must be present on pelvic examination to diagnose PID: Cervical motion tenderness Uterine tenderness Adnexal tenderness The following criteria can improve the specificity [aafp.org]
Patients with mucopurulent cervicitis and mild pelvic pain or tenderness and patients with abnormal bleeding with menses, mild pelvic pain, and uterine tenderness (representing endometritis) need to be treated for PID. [glowm.com]
Neurologic
- Headache
Twitter Instagram YouTube LinkedIn Search Home Specialties Topics Multimedia Current Issue Learning/CME Learning/CME CME Triglyceride Lowering with Pemafibrate to Reduce Cardiovascular Risk Case 36-2022: A 30-Year-Old Woman with Decreased Vision and Headache [nejm.org]
There may possibly be nausea, vomiting, hiccups, chills, fever, night sweats, headaches, and general malaise. There are often features of acute salpingitis but this is not invariable. [medigoo.com]
Common symptoms include severe pain in the upper right quadrant of the abdomen, fever, chills, headaches, and a general feeling of poor health (malaise). [speciality.medicaldialogues.in]
Other symptoms might include: Fever Chills Night sweat Nausea and vomiting Hiccups Headaches A general feeling of poor health (malaise) The symptoms of PID -- pain in the lower belly and vaginal discharge -- are often present, as well. [webmd.com]
[…] onset of severe pain in the upper right part of the abdomen, over the gallbladder Pain that may have moved to the right shoulder and inside of right arm Increasing pain with coughing, sneezing, or movement Nausea Vomiting Chills and fever Night sweats Headaches [verywell.com]
Workup
Thorough infectious workup and initial abdominopelvic imaging (computed tomography [CT] with contrast and ultrasound) were considered nonrevealing. [amjmed.com]
Fitz-Hugh-Curtis syndrome: An incidental diagnostic finding in an infertility workup. Niger J Clin Pract 2016;19:834-6 How to cite this URL: Onoh R C, Mgbafuru C C, Onubuogu S E, Ugwuoke I. [njcponline.com]
Fitz-Hugh-Curtis syndrome: An incidental diagnostic finding in an infertility workup. Niger J Clin Pract. 2016;19(6):834-6. Ikonomidis A, Strakas M, Stavrou AG, Papageorgiou E, Lainis A, Tsamparli M, et al. [medigraphic.com]
2016 16 Fitz-Hugh-Curtis Syndrome Consequent to a Wound Infection Following Removal of a Peritoneal Dialysis Catheter. ( 27903855 ) Zilberman-Daniels T....Korzets Z. 2016 17 Fitz-Hugh-Curtis syndrome: An incidental diagnostic finding in an infertility workup [malacards.org]
Laboratory
- Leukocytosis
Complete blood count showed a mild leukocytosis, and computed tomography demonstrated fat stranding inferior to the liver and along the right colon. [jetem.org]
She presented with pain in the right upper quadrant associated with fever and neutrophilic leukocytosis. She was a light smoker, nulliparous, and sexually active. [scielo.br]
Complete blood count (CBC) to assess for leukocytosis. Know, however, that only up to 50% of women with PID have a clinically significant leukocytosis. Blood cultures can vary and are generally negative in the setting of PID. [statpearls.com]
Treatment
Laparoscopic treatment of painful perihepatic adhesions in Fitz-Hugh-Curtis syndrome. Obstet Gynecol 1991;78:542–543. 11. Counselman FL. An unusual presentation of Fitz-Hugh-Curtis syndrome. J Emerg Med 1994;12:167–170. 12. [synapse.koreamed.org]
The abdominal symptoms, as well as the inflammatory markers, rapidly improved after starting doxycycline treatment. [amjmed.com]
Treatment / Management Treatment of HFCS coincides with the management of PID. The goals of treatment are to relieve symptoms, eradicate the infection, and minimize risks of long-term sequelae (infertility or ectopic pregnancy). [statpearls.com]
In conjunction with these findings, the patient was admitted for follow-up and treatment. [casereports.bmj.com]
Prognosis
Prognosis Prognosis is generally as for PID.[6] There may be no symptoms of Fitz-Hugh Curtis syndrome and it is found incidentally at operation at a later date. [patient.info]
(if necessary), the condition can be effectively managed Please find comprehensive information on Fitz Hugh Curtis Syndrome regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis [dovemed.com]
Prognosis The prognosis of the Fitz-Hugh-Curtis syndrome is the same as for the pelvic inflammatory disease. [hellomrdoctor.com]
These include: Ectopic pregnancy Cholecystitis Viral hepatitis Renal colic Pyelonephritis Pulmonary embolism Appendicitis Prognosis There is insufficient data documenting the prognosis of FHCS as it usually responds to antibiotics very well. [statpearls.com]
Etiology
Hysterosalpingography is one of the established studies that should be performed when the etiology of this inability is sought, especially when a possible tubal-peritoneal cause is suspected. [medigraphic.com]
First, the etiological factor was not assessed in this study. [scirp.org]
It has been demonstrated to occur in genital tuberculosis as well, and Mycobacterium tuberculosis may even be the dominating etiologic agent in endemic areas of developing countries 11,12. [radiopaedia.org]
The etiologic agent, NEISSERIA GONORRHOEAE, was isolated by Neisser in 1879. Definition (CSP) acute infectious disease characterized by primary invasion of the urogenital tract; the etiologic agent is Neisseria gonorrhoeae. [fpnotebook.com]
You are here: Urology Textbook > Penis > Sexually transmitted diseases > Gonorrhea > Pathogen and symptoms Gonorrhea (1/2): Etiology, Signs and Symptoms Gonorrhea (2/2): Diagnosis and Treatment Review-Literature: (CDC Guidelines, 2012) (IUSTI Guidelines [urology-textbook.com]
Epidemiology
Descriptive Epidemiology 587 Mechanisms and Routes of Transmission 7 Pathogenesis and Immunity 590 Patterns of Host Response 591 Control and Prevention 592 References 593 Suggested Reading 595 Rocky Mountain Spotted Fever Theodore E Woodward and J Stephen [books.google.com]
Epidemiology It affects between 4-14% of women who have PID. The epidemiology tends to mimic that of PID, affecting women of reproductive age and often younger women. [patient.info]
Epidemiology References: [1] [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015;28:603–661. 6. McMullan BJ, Campbell AJ, Blyth CC, et al. [journals.lww.com]
Epidemiology in Newfoundland and Labrador can be found in the Communicable Disease Report: Gonococcal: – http://www.health.gov.nl.ca/health/publichealth/cdc/mdr/Gonorrhoea_v28n1_June_2011.pdf Reference Values NOT DETECTED Interpretation NG DETECTED: indicates [publichealthlab.ca]
Pathophysiology
Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015;28:603–661. 6. McMullan BJ, Campbell AJ, Blyth CC, et al. [journals.lww.com]
[citation needed] Pathophysiology[edit] Fitz-Hugh–Curtis syndrome occurs almost exclusively in women. [en.wikipedia.org]
Prevention
Descriptive Epidemiology 587 Mechanisms and Routes of Transmission 7 Pathogenesis and Immunity 590 Patterns of Host Response 591 Control and Prevention 592 References 593 Suggested Reading 595 Rocky Mountain Spotted Fever Theodore E Woodward and J Stephen [books.google.com]
Can I Prevent Fitz-Hugh-Syndrome? Since this condition is linked to PID, the best way to prevent it is to not get PID. [webmd.com]
Prevention Prevention is as for PID. Historical aspects Fitz-Hugh and Curtis were not the first to describe the condition. In 1920 it was described by Stajano from Uruguay in an article in Spanish. [patient.info]