Question
Fitz-Hugh–Curtis syndrome, characterized by perihepatitis and right upper quadrant abdominal pain, is most commonly associated with which of the following infections?
| A. | Moniliasis |
| B. |
Syphilis |
| C. |
Tuberculosis |
| D. |
Gonorrhea |
Show Answer
|
Correct Answer » D Explanation |
 |
Fitz-Hugh–Curtis syndrome (FHCS) is a complication of pelvic inflammatory disease (PID) characterized by:
- Perihepatitis (inflammation of the liver capsule)
- Right upper quadrant abdominal pain
- “Violin-string” adhesions between the liver capsule and the anterior abdominal wall or diaphragm
The syndrome most commonly results from ascending genital tract infection caused by:
- Neisseria gonorrhoeae
- Chlamydia trachomatis (currently the most common cause)
Since Chlamydia is not among the options, Gonorrhea is the correct answer.
Explanation of Each Option
A. Moniliasis (Candidiasis) — Incorrect
- Caused by Candida albicans.
- Produces:
- Thick curdy white vaginal discharge
- Vulval itching
- Dyspareunia
- Does not cause PID or perihepatitis.
B. Syphilis — Incorrect
- Caused by Treponema pallidum.
- Characterized by painless chancre, rash, and systemic manifestations.
- Does not cause Fitz-Hugh–Curtis syndrome.
C. Tuberculosis — Incorrect
- Genital tuberculosis can cause infertility and chronic PID.
- Rarely, perihepatitis resembling Fitz-Hugh–Curtis syndrome may occur in endemic areas.
- However, it is not the most common cause.
- The uploaded notes mention that tuberculosis can occasionally produce a similar syndrome, but gonococcal and chlamydial infections are the classic causes.
D. Gonorrhea — Correct
- Caused by Neisseria gonorrhoeae.
- Common cause of PID.
- Infection may spread from the pelvis to the liver capsule, causing perihepatitis and right upper quadrant pain.
- Gonorrhea is one of the classical organisms associated with Fitz-Hugh–Curtis syndrome.