A 22-year-old sexually active woman presents with pelvic pain, cervical motion tenderness, and mucopurulent cervical discharge. The Fitz-Hugh-Curtis syndrome (perihepatitis) is noted on ultrasound (perihepatic adhesions). She is treated for PID. Which organism is most commonly associated with Fitz-Hugh-Curtis syndrome complicating PID?
- A Neisseria gonorrhoeae exclusively
- B Chlamydia trachomatis (more commonly than N. gonorrhoeae in modern studies) ✓
- C Mycoplasma genitalium
- D Trichomonas vaginalis
Explanation
Fitz-Hugh-Curtis syndrome (perihepatitis) is inflammation of the liver capsule and perihepatic adhesions forming 'violin string' adhesions between the anterior liver surface and the anterior abdominal wall, causing right upper quadrant pain alongside PID. Historically attributed to Neisseria gonorrhoeae, modern studies have shown Chlamydia trachomatis to be the more common causative organism, as chlamydial antibody titres (anti-chlamydial IgG) correlate strongly with perihepatic adhesion formation. Both organisms can cause Fitz-Hugh-Curtis syndrome. Mycoplasma genitalium and Trichomonas are not associated with this syndrome.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.