Incidence of Fitz-Hugh–Curtis Syndrome in Adolescents Who Have Pelvic Inflammatory Disease

Abstract 

Purpose

We determined the incidence of Fitz-Hugh–Curtis syndrome (FHCS) in adolescents who had mild to moderately severe pelvic inflammatory disease (PID).

Design

Prospective cohort study.

Setting

Harris County Juvenile Detention Center, April 2000–April 2006.

Participants

Incarcerated female adolescents.

Intervention

In patients who met accepted criteria for the diagnosis of PID, we determined the proportion that had right upper quadrant pain that responded to therapy for PID. They were diagnosed as having FHCS.

Results

The 117 subjects' mean age (SD) was 15.6 (1.8) years; 37% were Hispanic, 34% black, and 26% white. 5/117 (4.3%, 95% confidence interval 1.4–9.7%) had symptomatic FHCS. Fifteen (13%) of all subjects, including 1 with FHCS, had fever and/or nausea and vomiting (moderately severe PID): none had generalized peritonitis or tubo-ovarian abscess (severe PID). Thirty-four had chlamydial, 4 gonorrheal, and 9 combined infections. All improved with standard outpatient PID therapy.

Conclusion

FHCS was uncommon (4%) in adolescents who had mild to moderate PID and chlamydia as the most common pathogen.

Key Words: Pelvic inflammatory disease, Fitz-Hugh, Curtis syndrome, Perihepatitis, Epidemiology