Chlamydia Peritonitis and Ascites Mimicking Ovarian Cancer

Gojayev, Anar; English, Diana P.; Macer, Matthew; Azodi, Masoud

doi:10.1155/2016/8547173

Cited by 9 publications

(6 citation statements)

References 5 publications

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“…There are a few case reports that describe PID-induced ascites that initially mimicked either tuberculous peritonitis or peritoneal carcinomatosis, with elevated adenosine deaminase levels in the ascitic fluid, postinflammatory peritoneal nodularity on imaging, or pelvic cystic masses on imaging 5 11. Although our patient did have mild peritoneal enhancement on imaging, there were no cysts on imaging, the ascitic fluid adenosine deaminase level was normal with negative ascitic and blood tests for tuberculosis, and no malignant cells were seen on cytology.…”

Section: Discussionmentioning

confidence: 64%

Chlamydiaascites: a call for sexually transmitted infection testing

et al. 2018

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A 26-year-old gravida 2, para 2-0-0-2 woman with a recent uncomplicated vaginal delivery 10 weeks prior presented to our hospital with 5 weeks of abdominal swelling and discomfort. Four weeks after delivery, the patient began having right upper quadrant pain and was found to have cholelithiasis. She underwent an elective laparoscopic cholecystectomy 6 weeks prior to admission, but started to develop worsening abdominal swelling 1 week postoperatively. Abdominal distension and shifting dullness were present on examination. CT of the abdomen and pelvis was remarkable for moderate-volume ascites and mild enhancement of the pelvic peritoneum. Paracentesis removed 2.46 L of ascites fluid with 76% lymphocytic predominance. Results for Chlamydia trachomatis were positive in urine, cervical swab and ascitic fluid. Doxycycline was prescribed for a diagnosis of pelvic inflammatory disease exudative ascites. Since discharge, she has completed her antibiotic course and reports resolution of all symptoms without recurrence of ascites.

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Section: Discussionmentioning

confidence: 64%

Chlamydiaascites: a call for sexually transmitted infection testing

et al. 2018

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“…Wolner-Hanssen et al isolated C. trachomatis from an infected patient's liver capsule in 1982, confirming the association [14]. Since then, several authors have reported cases of complicated chlamydial infections causing ascites with or without perihepatitis in multiple contexts [5,[15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 88%

A Rare Case of Lymphocytic Ascites

Sivaprakasam,

Ali,

Jasti

et al. 2024

Cureus

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Ascites can manifest as a result of many conditions, with cirrhosis being the most common cause in the United States. Here, we present a case of lymphocytic ascites, a less common variant that occurred due to infection with Chlamydia trachomatis. This was a 37-year-old female with a history of substance and sexual abuse who presented with the chief complaints of abdominal pain, abdominal distension, and weight gain. She was febrile on admission with a distended, tender abdomen. The more common cardiac, renal, and hepatic causes were ruled out with extensive workup. Diagnosis and therapeutic paracentesis were done with fluid analysis significant for lymphocyte predominance and absence of malignant cells. Multi-modal imaging had ruled out suspicious malignant masses but CT abdomen/pelvis did show complex large volume ascites. Urine chlamydia and gonorrhea polymerase chain reaction (PCR) had resulted positive for chlamydia, leading us to start Doxycycline. Other infectious workups were negative, but ascitic fluid chlamydia NAAT was positive. Though initially worsening, the patient started showing significant clinical improvement after starting doxycycline, with the resolution of ascites and associated symptoms. This case report intends to bring to attention the importance of testing for chlamydia infection in cases of lymphocytic ascites, especially in sexually active females.

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“…C. trachomatis infections may occur in multiple organs, including the lungs, lymph nodes, peritoneal cavity, and genitourinary systems. Therefore, CT and PET-CT examinations may resemble ovarian malignancies [ 3 ]. In this case, C. trachomatis and N. gonorrhoeae DNA probe tests were not performed because the patient said that she had no history of sexual intercourse.…”

Section: Discussionmentioning

confidence: 99%

“…C. trachomatis infections may occur in multiple organs, including the lungs, lymph nodes, peritoneal cavity, and genitourinary systems, among young women. Pelvic inflammatory disease (PID) due to C. trachomatis may result in significant ascites, pelvic masses, cul-de-sac nodularity on an exam, elevated levels of the serum tumor marker CA125, and imaging findings that mimic ovarian malignancy [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Chlamydia Peritonitis Mimicking Juvenile Carcinomatous Peritonitis Diagnosed by Exploratory Laparoscopy: A Case Report

et al. 2023

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Chlamydia trachomatis infections may occur in multiple organs, including the lungs, lymph nodes, peritoneal cavity, and genitourinary systems. This disease results in significant ascites, the swelling of lymph nodes, and elevated tumor markers (CA125), sometimes mimicking an ovarian malignancy. At our hospital, we often perform examination laparoscopic surgery in cases of suspected gynecologic cancers before initial treatment. In this paper, we report the case of a 19-year-old woman who came to our hospital because of an ovarian tumor and ascites. There was no history of sexual intercourse (self-reported). We suspected ovarian cancer from image inspections, so we performed laparoscopic surgery for diagnosis. The final pathological diagnosis was acute-to-chronic inflammation of the bilateral fallopian tubes, and a cytologic examination of the ascites was negative for malignant cells. The C. trachomatis antigen was positive on vaginal examination after the operation. Based on this result, we diagnosed this patient with C. trachomatis infection. Chlamydia peritonitis should be a differential diagnosis for cancer peritonitis in juvenile patients with abnormal ascites. Exploratory laparoscopy should help confirm the pathological diagnosis.

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Chlamydia Peritonitis and Ascites Mimicking Ovarian Cancer

Cited by 9 publications

References 5 publications

Chlamydiaascites: a call for sexually transmitted infection testing

Chlamydiaascites: a call for sexually transmitted infection testing

A Rare Case of Lymphocytic Ascites

Chlamydia Peritonitis Mimicking Juvenile Carcinomatous Peritonitis Diagnosed by Exploratory Laparoscopy: A Case Report

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