Presentation
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]
We present a case of Fitz-Hugh Curtis syndrome associated with tuberculous salpingitis and peritonitis, presenting with new onset ascites. [bmcgastroenterol.biomedcentral.com]
You will be able to get a quick price and instant permission to reuse the content in many different ways. obstetrics and gynaecology infectious diseases Description A 29-year-old woman presented with 2 days of right upper abdominal pain. [casereports.bmj.com]
Approximately 4 months before presentation, she had received a diagnosis of and been treated for pelvic inflammatory disease. [speciality.medicaldialogues.in]
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]
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]
Case Report A 17-years-old adolescent, with no relevant personal history, presented with fever, vomiting, diarrhea and constant abdominal pain. [pediatriconcall.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]
- Chills
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]
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]
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]
- Asymptomatic
However, at least 50% of infected women are asymptomatic. [www2a.cdc.gov]
Genital gonorrhea, the usual source of disseminated infection, may be asymptomatic. [merckmanuals.com]
Asymptomatic persons. B. Patients who do not seek treatment may become asymptomatic carriers C. All of the above As many as 50% of women and 5% of men will not experience recognizable symptoms. [meddean.luc.edu]
Follow-up in Recurring/Chronic Cholecystitis:- Asymptomatic Patients:- - 1% will become symptomatic per year - most will develop symptoms before complications - indicators for surgery in an asymptomatic patient (rare): - access to medical care porcelain [tcd.ie]
Most had asymptomatic anogenital infections, and dissemination arose during pregnancy or menstruation in 71%. Arthritis occurred in 38 patients, in whom a characteristic clinical picture was seen. [annals.org]
- Severe Pain
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]
Fitz-Hugh-Curtis syndrome is marked by sudden, severe pain in the upper right area of your belly, just below the ribs. You might also feel pain on your right shoulder and right arm. Moving usually makes it worse. [webmd.com]
Others may have some or all of the following 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 [verywell.com]
Common symptoms include severe pain in the upper right area (quadrant) of the abdomen, fever, chills, headaches, and a general feeling of poor health (malaise). [rarediseases.org]
- Unsafe Sexual Practices
[…] partners, avoiding unsafe sexual practices, and routinely using appropriate barrier protection. [emedicine.medscape.com]
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]
The right upper abdominal pain appears as the main symptom and becomes more severe in response to deep breathing and body movements. Occasionally, the pain may radiate to the right shoulder. [casereports.bmj.com]
According to history, a 62-year-old woman presented to the surgical outpatient clinic with a 3-month history of intermittent abdominal pain in the right upper quadrant. [speciality.medicaldialogues.in]
This syndrome usually presents with right upper quadrant (RUQ) abdominal pain together with lower abdominal pain and vaginal discharge. [elsevier.es]
This pain could be explained by the appearance of perihepatic inflammation and the formation of adhesions between the Glisson capsule and the anterior abdominal wall. It may be accompanied by lower abdominal, dorsal, or pelvic pain. [ijcasereportsandimages.com]
- 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]
Patients with FHCS may present with fever, nausea, vomiting, RUQ abdominal pain, pelvic pain, vaginal discharge, abnormal vaginal bleeding, etc. [1]. [hindawi.com]
Other symptoms may also be experienced such as fever, chills, nausea and vomiting, vaginal discharge, dysuria, etc. [6],[7]. Fitz-Hugh-Curtis’s syndrome may mimic a number of other diseases. [ijcasereportsandimages.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]
- 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]
Physical examination revealed RUQ abdominal tenderness and vaginal secretions, pelvic pain that was denied by the patient. [ijcasereportsandimages.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]
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]
- Hiccup
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]
[…] 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 Hiccupping [verywell.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]
- Right Upper Quadrant Tenderness
She presented with subsequent right upper quadrant abdominal tenderness. [primescholars.com]
Symptoms may include fever, pleuritic pain, right upper quadrant tenderness, and/or cervical motion tenderness [1]. [hindawi.com]
Abdominal exam: Right upper quadrant tenderness, rebound tenderness, guarding, or a silent abdomen. Pelvic exam: Cervical motion tenderness, adnexal tenderness, uterine compression tenderness on bimanual examinations. [statpearls.com]
These patients appear septic as well, and often present with right upper quadrant or referred right shoulder pain. Elevated liver function studies confirm the diagnosis. [cdemcurriculum.com]
Liver, Gall & Pancreas
- Hepatomegaly
The ultrasound showed hepatomegaly with no gallbladder and appendiceal pathologies. Abdominal contrast-enhanced CT scan (figure 1) showed hepatomegaly with an enhancement of the hepatic capsule of the right lobe. [casereports.bmj.com]
Ascending cholangitis Acalculous cholecystitis Peptic ulcer disease with or without perforation Pancreatitis Acute hepatitis Pyelonephritis Pneumonia Kidney stone Pancreatitis GERD Appendicitis (retrocecal) Pyogenic liver abscess Fitz-Hugh-Curtis Syndrome Hepatomegaly [wikem.org]
A computed tomography (CT) scan was finally performed 7 days after admission which showed hepatomegaly, piosalpinx and tubo-ovarial abscesses, all consistent with pelvic inflammatory disease (Fig. 1). [elsevier.es]
A right upper quadrant ultrasound revealed gallbladder sludge, mild hepatomegaly, and hepatic steatosis. A hepatobiliary iminodiacetic acid (HIDA) scan showed no evidence of cystic or common bile duct obstruction. [hindawi.com]
Computed tomography scans can also show a hepatomegaly and intraparenchymal reversible dynamic perfusion abnormalities [10]. Infertility is the most common complication of FHCS. [ijcasereportsandimages.com]
- 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]
Urogenital
- Vaginal Discharge
Culture of urethral discharge was positive for N. gonorrhoeae, PCRs for C. trachomatis and Mycoplasma hominis were positive on vaginal discharge. [pediatriconcall.com]
The patient did not complain of any current or recent vaginal discharge, urinary symptoms, or discomfort during intercourse. She noticed a low-grade fever (a temperature of 37.5°C per mouth was noted on admission). [amjmed.com]
With a medical interview of her sexual activity, FHCS was suspected and confirmed by a plain computed tomography, Gadolinium-enhanced magnetic resonance imaging and a detection of Chlamydia trachomatis in her vaginal discharge. [gynecology-obstetrics.imedpub.com]
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]
Also began treatment with clotrimazole vaginal tablets showing improvement of itching and vaginal discharge. [scielo.isciii.es]
- 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 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]
September 1988 Am J Dis Child. 1988;142(9):996-998. doi:10.1001/archpedi.1988.02150090094033 Full Text • We encountered seven female adolescents with the Fitz-Hugh-Curtis syndrome and no signs or symptoms of salpingitis. [jamanetwork.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]
- Dyspareunia
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]
In symptomatic cases, typical clinical symptoms include purulent vaginal or urethral discharge, dysuria, and signs of epdidymitis (e.g., scrotal pain ) or PID (e.g., pelvic pain, dyspareunia ). [amboss.com]
After 1 month the clinical status of the patient is reviewed and a new analytical control is performed, finding her in good general condition without vaginal discharge, dyspareunia, superficial and deep abdominal pain to palpation. [scielo.isciii.es]
[…] uterine instrumentation.6,7,8 The use of barrier contraceptive methods is a protective factor.8 Although not pathognomonic, clinical signs have a sensitivity of 65-90% for the diagnosis of the disease, which could present with abdominal or pelvic pain, dyspareunia [pediatriconcall.com]
The symptoms are varied, ranging from simple non-specific pain in the hypogastric region, dysuria and dyspareunia to excessive vaginal secretions (3,9). [scielo.br]
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]
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]
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]
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]
Microbiology
- Chlamydia
Chlamydia trachomatis as possible cause of peritonitis and perihepatitis in young women. Br Med J 1978;1:1022–1024. 4. Joo SH, Kim MJ, Lim JS, Kim JH, Kim KW. CT diagnosis of Fitz-Hugh and Curtis syndrome: value of the arterial phase scan. [synapse.koreamed.org]
At that time, the concentration of anti-chlamydia antibodies was slightly higher as compared to prior to beginning treatment for FHCS (anti-chlamydia IgG cut-off index (COI) 2.765, anti-chlamydia IgA COI 8.746). [link.springer.com]
A chlamydia DNA probe test was positive, and the diagnosis of Fitz-Hugh-Curtis syndrome was made. 1. [hindawi.com]
Chlamydia trachomatis as possible cause of peritonitis and perihepatitis in young women. Br Med J 1978;1:1022-1024 Wang SP et al. Chlamydia trachomatis infection in Fitz-Hugh-Curtis syndrome. [lifeinthefastlane.com]
Chlamydia trachomatis is one of its most common aetiologies. [bmcresnotes.biomedcentral.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]
The treatment of Fitz-Hugh-Curtis syndrome is directed toward the specific symptoms that are apparent in each individual. [speciality.medicaldialogues.in]
Most patients improved following antibiotic treatment. Moreover, the lesions were absent on abdominal CT scan performed after the treatment (Figure 1). [wjgnet.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
First, the etiological factor was not assessed in this study. [scirp.org]
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]
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]