A 24-year-old woman with cervicitis presents with right upper quadrant pain, fever, and elevated liver enzymes. Laparoscopy shows 'violin string' adhesions between the liver capsule and parietal peritoneum. Which organism is the most common cause of this syndrome along with Chlamydia trachomatis?
- A Treponema pallidum
- B Neisseria gonorrhoeae ✓
- C Haemophilus ducreyi
- D Klebsiella granulomatis
Correct answer: B. Neisseria gonorrhoeae
Explanation
This is Fitz-Hugh-Curtis syndrome, perihepatitis complicating pelvic inflammatory disease. It is caused by Neisseria gonorrhoeae and Chlamydia trachomatis, with inflammation tracking along the paracolic gutters to the liver capsule producing violin string adhesions. Treponema pallidum causes hepatitis in secondary syphilis but not perihepatic adhesions, while Haemophilus ducreyi and Klebsiella granulomatis remain localized to genital ulcer disease without upper abdominal spread.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.