Acute Fitz-Hugh-Curtis Syndrome in a Man due to Gonococcal Infection

Nardini, Paola; Compri, Monica; Marangoni, Antonella; D’Antuono, Antonietta; Bellavista, Sara; Calvanese, Claudio; Belluzzi, Andrea; Bazzoli, Franco; Montagnani, Marco

doi:10.1016/j.jemermed.2014.04.043

Cited by 15 publications

(15 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In 1985, Winkler et al 20 first mentioned perihepatitis in an MSM patient with impaired cellular immunity, but it was considered to be related to an acute cytomegalovirus infection. In some reports, the etiology was not established, but the imaging methods of the abdomen showed liver capsule enhancement 1,9 or the adhesions were directly visualized by laparoscopy. 21…”

Section: Discussionmentioning

confidence: 99%

“…Neisseria gonorrhoeae was originally considered to be the main pathogen, but it was later discovered that Chlamydia trachomatis also plays an important role. 5,6 The infection is usually spread per continuitatem 7 through the right paracolic space, by blood or by lymphatic fluid, 8,9 selectively affecting the liver capsule. 7 The inflammation results in the formation of gentle fibrin adhesions (‘violin strings’) between the surface of liver, diaphragm, and the abdominal wall, which causes RUQ pain, a characteristic symptom of FHCS.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A rare case of Fitz-Hugh–Curtis syndrome caused by Chlamydia trachomatis in an HIV-positive male patient

Lisičar

Begovać

Zekan

2019

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

Fitz-Hugh–Curtis syndrome, a rare complication of pelvic inflammatory disease, is an inflammation of the liver capsule (thus called perihepatitis) and the surrounding peritoneum. It occurs extremely rarely in men and is typically characterized by a sudden onset of severe pain in the right upper abdominal quadrant. Ultrasound examination of the liver does not reveal any morphologic changes, and liver function tests are usually normal. Computerized tomography shows the thickening of the perihepatic fat, but definitive diagnosis is only possible by direct visualization by laparoscopy or laparotomy. We present a 33-year-old HIV-positive man with Chlamydia trachomatis proctitis who developed severe right upper abdominal quadrant pain. Abdominal ultrasound did not show any liver pathology, while computerized tomography revealed hepatic capsular thickening. After 21 days of doxycycline therapy, the patient’s symptoms subsided. Based on the clinical presentation and liver computerized tomography examination, the diagnosis of proctitis and the resulting Fitz-Hugh–Curtis syndrome was made. Although it is rarely seen in male patients, it should be a part of differential diagnosis in patients who present with right upper abdominal quadrant pain, especially in men who have sex with other men.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A rare case of Fitz-Hugh–Curtis syndrome caused by Chlamydia trachomatis in an HIV-positive male patient

Lisičar

Begovać

Zekan

2019

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

show abstract

“…Nardini et al 11 described in 2014 the case of a 26-year-old male who attended the emergency department with complaints of right upper quadrant abdominal pain, accompanied by painful urination and a recent history of risky sexual encounters. On abdominal ultrasound, a small amount of perihepatic fluid was observed, and urethral smear tests were positive for C. trachomatis and N. gonorrhoeae.…”

Section: Discussionmentioning

confidence: 99%

Fitz-Hugh-Curtis syndrome in elderly male patient. Case and literature review

Freiria-Eiras¹,

Varela-Lamas²

2019

CIRUE

View full text Add to dashboard Cite

Fitz-Hugh-Curtis syndrome (FHCS) is the inflammation of the hepatic capsule without affecting the parenchyma, which is associated with a pelvic inflammatory disease. There have been very few cases in men. The main symptom is abdominal pain in the right upper quadrant, which can be confused with a bile duct disorder. Strong violin string-like adhesions between the diaphragm and the liver are characteristic. In the study concerned, it is reported the case of an 81-year-old man who undergoes a laparoscopic cholecystectomy for recurrent pancreatitis. During surgery, the typical violin string-like adhesions are found and sectioned. The patient tests positive for Chlamydia trachomatis antibodies. Only nine cases in men have been reported in FHCS literature. This syndrome is frequently confused with infectious biliary tract disease, so the patient should undergo a surgery to diagnose when the characteristic adhesions are found. If the disease is suspected by the additional tests, it can be treated with antibiotics.

show abstract

“…Untreated gonorrhoea can be a cause of ascendant prostatitis, vasitis, orchiepididymitis and other non-urogenital conditions [4]. Had the patient reported that he had not taken the prescribed treatment for his gonorrhoea, this would have been taken into account, radiological exploration would probably not have been carried out and surgical intervention would have not been undertaken.…”

Section: Discussionmentioning

confidence: 99%