Fitz-Hugh-Curtis syndrome (FHCS) is a rare complication of pelvic inflammatory disease (PID). FHCS occurs almost exclusively in females and causes symptoms such as abdominal pain, fever, and malaise.
Other names for FHCS may include gonococcal perihepatitis and perihepatitis syndrome. The condition occurs as a potential complication of PID, when a person
In this article, we will discuss FHCS, including the symptoms, treatments, causes, and risk factors for the condition.
A note about sex and gender
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FHCS describes an uncommon complication of PID. It occurs when inflammation from PID spreads to the membrane lining of the stomach and tissues surrounding the liver. In some cases, it may also affect the diaphragm.
FHCS occurs almost exclusively in females and most often affects sexually active females between 15 and 30 years of age. Though there are around
There are a few factors that can increase a person’s risk of developing PID. These
- having an untreated STI
- having more than one sexual partner
- having a sexual partner who has other sexual partners
- having had PID before
- being sexually active and being 25 years old or younger
- using a douche
Using an intrauterine device (IUD) for birth control can also cause a slight increased risk of PID. However, this risk is less likely to occur after the first 3 weeks after the doctor has placed the IUD inside the uterus.
Other possible symptoms of FHCS may include:
- lower abdominal pain
- pelvic pain
- back pain
- nausea and vomiting
- vaginal discharge
- painful sexual intercourse, which doctors call dyspareunia
- painful urination, which doctors call dysuria
- bleeding after sexual intercourse
FHCS may have similar symptoms to several other conditions. As such, a doctor may carry out a differential diagnosis to rule out
- ectopic pregnancy
- cholecystitis, swelling or inflammation of the gallbladder
- viral hepatitis
- renal colic
- pyelonephritis, a kidney infection due to bacteria or a virus
- pulmonary embolism
During a diagnosis, a doctor may carry out one of the following lab tests:
- Pregnancy test: A doctor may carry out a pregnancy test to guide their choice of antibiotic therapy and help address whether the person has an ectopic pregnancy.
- Complete blood count (CBC): A doctor may use a CBC to look for a high white blood cell count. Around 50% of people with PID have a significantly raised white blood cell count.
- Comprehensive metabolic panel: This test can help a doctor assess a person’s electrolyte levels as well as any atypical liver or kidney readings.
- Sexually transmitted infection test: This can test for chlamydia and gonorrhea, which can indicate that a person may have FHCS.
A doctor may also carry out a CT scan. This scan
A doctor may also use a laparoscopy to help make a diagnosis. During this procedure, a doctor
A doctor will often treat a person’s PID alongside their FHCS. The main aims of treatment
- relieving symptoms
- eradicating the infection
- minimizing the risks of long-term complications, such as infertility or ectopic pregnancy
A doctor will most often use antibiotics to treat the infection. This treatment is typically effective, and most people with PID can receive treatment as outpatients.
A doctor may wish to treat a person in a hospital if they:
- have an uncertain diagnosis
- are pregnant
- are displaying signs of a severe illness
- have pelvic abscesses
- are unable to tolerate taking medications orally
- have an immunodeficiency
- show no signs of improvement after 72 hours of treatment
FHCS is a potential and uncommon complication of PID that occurs almost exclusively in females. It occurs when a PID spreads to the liver, causing inflammation in the tissues surrounding the liver. This often causes uncomfortable symptoms, such as severe pain in the right upper abdominal quadrant.
A doctor may carry out blood tests and imaging tests to help diagnose FHCS. Typically, a healthcare professional can use a laparoscopy to confirm the diagnosis. Treatment for FHCS often involves antibiotics, which aim to relieve symptoms and eradicate the infection causing the PID. FHCS usually responds well to antibiotics, often leading to a full recovery and no long-term complications.