A 22-year-old woman presents with bilateral lower abdominal pain, fever 38.5°C, cervical motion tenderness, and mucopurulent cervical discharge. She has an IUD in situ. Endocervical swab is pending. The Fitz-Hugh-Curtis syndrome is a complication of PID caused by perihepatitis from which organisms?
- A Chlamydia trachomatis only
- B Neisseria gonorrhoeae only
- C Both Chlamydia trachomatis and Neisseria gonorrhoeae ✓
- D Mycoplasma genitalium and Trichomonas vaginalis
Correct answer: C. Both Chlamydia trachomatis and Neisseria gonorrhoeae
Explanation
Fitz-Hugh-Curtis syndrome (perihepatitis) is characterized by violin-string perihepatic adhesions and right upper quadrant pain due to ascending pelvic infection to the liver capsule. It is associated with both Chlamydia trachomatis (more commonly via lymphatic spread) and Neisseria gonorrhoeae (via direct transperitoneal spread). Historically attributed to gonococcal PID, subsequent evidence showed Chlamydia is the more frequent causative agent. Both organisms are implicated, and it presents with PID symptoms plus pleuritic RUQ pain.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.