Clinical outcome of Fitz-Hugh-Curtis syndrome mimicking acute biliary disease

Table 1 Clinical manifestation of 22 patients with Fitz-Hugh-Curtis syndrome

	mean ± SD (range)
Age (yr)	31.0 ± 8.1 (19-49)
Last intercostal history (d)	11.0 ± 10.9 (3-30)
Hospital visit duration (d)	5.8 ± 4.5 (0-14)
	Number (%)
Chief complaints
RUQ pain	7 (32)
RUQ and lower abdominal pain	7 (32)
Lower abdominal pain	6 (27)
Epigastric pain	1 (4.5)
Fever and lymphadenopathy	1 (4.5)
First impression
Acute cholecystitis	10 (46)
Acute appendicitis	5 (23)
Pelvic inflammatory disease	3 (13)
Peritonitis	1 (4.5)
Hepatitis	1 (4.5)
Gastric ulcer	2 (9)

Table 2 Laboratory and radiographic study of 21¹ patients with Fitz-Hugh-Curtis syndrome, which was diagnosed by abdominal CT

	mean ± SD (range)
Laboratory study (n = 21)
WBC (1000/mm3)	11.5 ± 3.4 (3.5-16.2)
AST (IU/L)	22.1 ± 30.1 (10-156)
ALT (IU/L)	17.0 ± 24.8 (5-126)
ESR (mm/h)	51.2 ± 28.9 (18-120)
CRP (mg/L)	52.1 ± 41.9 (2-154)
	Positive result of number (%)
Serologic test or PCR (n = 21)
C. trichomatis	18 (85.7)
T. vaginalis	1 (4.8)
U. urealyticum	1 (4.8)
M. hominis	1 (4.8)
Microbiologic culture (n = 21)
S. agalactiae	3 (14.3)
U. urealyticum	1 (4.8)
S. aureus	1 (4.8)
C. albicans	1 (4.8)
E. coli	1 (4.8)
	Positive result of number (%)
Radiographic study2
Abdomen CT (n = 21)	21 (100)
Abdomen ultrasonography (n = 10)	0 (0)

¹Among the 22 patients, one was diagnosed by laparoscopic surgery without a study;

²Abdominal CT was performed in 21 patients, and only 10 patients among them were investigated by abdominal ultrasonography.

Table 3 Clinical characteristics of 22 patients with Fitz-Hugh-Curtis syndrome

No.	Age	Symptom (pain)	Duration	Impression	Diagnosis	Treatment	Prog
1	39	Low abdomen	5	PID	CT	Doxycycline
2	23	RUQ	7	Cholecystitis	CT	Doxycycline
3	35	RLQ	5	Appendicitis	CT + Sono	Cepha + Amino + Metro
4	19	Low abdomen	5	Appendicitis	CT + Sono	Doxycycline
5	22	RUQ	7	Cholecystitis	CT + Sono	Cepha + Amino + Metro
6	29	RUQ + low abdomen	6	Appendicitis	CT + Sono	Cepha + Metro
7	26	RUQ	3	Cholecystitis	CT	Cepha + Amino + Metro
8	21	Epigastrium	3	Gastric ulcer	CT + Sono	Cepha + Amino + Metro
9	37	Fever	10	Hepatitis	CT	Doxycycline
10	41	RUQ	14	Cholecystitis	CT	Amp + Amino + Metro
11	49	Low abdomen	10	PID	CT	Amp + Amino + Metro
12	33	RUQ + low abdomen	0	Cholecystitis	CT	Doxycycline
13	45	RUQ	1	Cholecystitis	CT + Sono	Cepha + Metro
14	32	RUQ	5	GB stone	CT + Sono	Amp + Amino+ Metro
15	34	RUQ + low abdomen	14	PID	CT + Sono	Cepha + Amino + Metro	Lapa
16	27	RUQ + low abdomen	2	GB stone	CT + Sono	Cepha + Amino + Metro
17	31	Low abdomen	14	Pyelonephritis		Amp + Amino	Lapa
18	25	RUQ + low abdomen	1	Cholecystitis	CT	Amp + Amino + Metro
19	38	RUQ + low abdomen	1	Appendicitis	CT + Sono	Amp + Amino + Metro
20	33	RLQ	4	Appendicitis	CT	Amp + Amino + Metro
21	22	RUQ + low abdomen	1	Cholecystitis	CT	Amp + Amino + Metro
22	27	RUQ pain	10	Gastritis	CT	Amp + Amino + Metro

RUQ: Right upper quadrant abdominal; RLQ: Right lower quadrant abdominal; PID: Pelvic inflammatory disease; GB: Gallbladder; CT: Computed tomography; Sono: Ultrasonography; Cepha: Cephalosporin; Amino: Aminoglycoside; Metro: Metronidazole; Amp: Ampicillin/sulbactam; Prog: Prognosis; Lapa: Laparoscopic adhesiolysis.