Fitzhugh Curtis Syndrome

7 Sep
Fitzhugh-Curtis Syndrome is an inflammation of the lining of the liver associated with GU infection
 
It occurs in up to 25% of women with PID. Adolescents are especially susceptible because of their immature anatomy
 
Pathogenesis – may involve direct, hematogenous, or lymphatic spread of N gonorrhea or C trachomatis to the liver capsule
 
Diagnosis of exclusion, after ruling out other causes of RUQ pain. Liver enzymes are often normal or only mildly elevated. Definitive diagnosis can only be made by directly visualizing the liver, but clinical diagnosis is sufficient to treat.
 
Treat as PID, and the RUQ pain should resolve
 
If RUQ pain does not resolve, laparotomy or laparoscopy can confirm the diagnosis and rule out alternative causes of RUQ pain, but long-term complications of perihepatitis are rare. Long-term complications of PID are of greater concern.
 
Submitted by M. Smith.
 
Reference: Peter NG, Clark LR, Jaeger JR. Fitz-Hugh-Curtis Syndrome: A diagnosis to consider in women with right upper quadrant pain. Cleve Clin J Med. 2004 Mar;71(3):233-9.
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