A case of Fitz-Hugh-Curtis syndrome diagnosed by noninvasive metagenomic next-generation sequencing

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology Pub Date : 2024-10-29 DOI:10.1016/j.tjog.2024.04.020

Chengcheng Ding , Run Chen , Peng Guo , Juhua Yang , Mian He

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Abstract

Objective

Fitz-Hugh-Curtis Syndrome (FHCS) is an inflammation of the liver capsule as a complication of pelvic inflammatory disease (PID) in sexually active women, mostly associated with Chlamydia trachomatis (C. trachomatis) and Neisseria gonorrhoeae. Classically presenting as sharp right upper quadrant pain, usually accompanied salpingitis and ascites. With nonspecific clinical presentation and poor specificity, definitive diagnosis needs tissue biopsy and culture by laparoscopy.

Case report

We report the case of a 22-year-old female with a 2-month history of abdominal pain and distention. Symptomatic relief when supportive treatments were given, with the ultrasound and PET-CT suggested advanced bilateral ovarian cancer. After metagenomic next-generation sequencing (mNGS) detected C. trachomatis in ascitic fluid. Following anti-infective medication, clinical improvement was satisfactory and the patient was discharged.

Conclusion

FHCS with distention was rare and challenging to diagnose. The mNGS would be a potent, non-invasive pathogen detection method with significant sensitivity and specificity.

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通过无创元基因组下一代测序诊断出的一例菲茨-休-柯蒂斯综合征病例

目的菲茨-休-柯蒂斯综合征（FHCS）是性活跃期妇女盆腔炎（PID）的并发症之一，主要与沙眼衣原体（C. trachomatis）和淋病奈瑟菌（Neisseria gonorrhoeae）有关。典型表现为右上腹剧烈疼痛，通常伴有输卵管炎和腹水。临床表现无特异性，特异性差，确诊需要通过腹腔镜进行组织活检和培养。病例报告我们报告了一例 22 岁女性的病例，她有 2 个月的腹痛和腹胀病史。给予支持性治疗后症状缓解，超声和 PET-CT 提示为双侧卵巢癌晚期。经过元基因组下一代测序（mNGS）在腹水中检测到沙眼衣原体。抗感染药物治疗后，患者的临床症状得到了满意的改善，并康复出院。mNGS 是一种有效的非侵入性病原体检测方法，具有显著的灵敏度和特异性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Taiwanese Journal of Obstetrics & Gynecology OBSTETRICS & GYNECOLOGY-

CiteScore

3.60

自引率

23.80%

发文量

207

审稿时长

4-8 weeks

期刊介绍： Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology. The aims of the journal are to: 1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health 2.Deliver evidence-based information 3.Promote the sharing of clinical experience 4.Address women-related health promotion The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.