Acute abdominal pain in a 24-year-old woman: Fitz-Hugh-Curtis syndrome associated with pyelonephritis

Fitz-Hugh-Curtis syndrome is an inflammatory disease ofthe liver capsule that occurs as a complication of pelvicinflammatory disease in approximately 25% of cases. Themost common etiological agents are Chlamydia trachomatisand Neisseria gonorrhoeae. Classically, it manifests as acuteright upper quadrant pain, which can sometimes beconfused with pyelonephritis or a primitive condition ofhepatobiliary origin or the digestive tract. A correctdiagnosis is often difficult. Ultrasonography and computedtomography (CT) may be helpful in the differentialdiagnosis of other forms of peritonitis localized in the rightabdominal quadrants, and serology, urine cultures andcervical swabs are generally used to isolate the responsibleorganism. The differential diagnosis could include Chilaiditisyndrome (interposition of a colonic segment between theliver and diaphragm with occlusion) or exudative peritoni-tis from salpingitis. We describe the clinical case of a 24-year-old Caucasian woman who presented with acute rightupper quadrant pain, positive Murphy’s sign, neutrophilicleukocytosis, and fever.