Document 0249
 DOCN  M9590249
 TI    Chlamydia trachomatis Fitz-Hugh Curtis syndrome. A cause of ruq pain in
       a man with HIV infection--case report.
 DT    9509
 AU    Fuller A; Spelman D; Spicer WJ; Johnson W; Garland S; Alfred Hospital,
       Prahran.
 SO    Annu Conf Australas Soc HIV Med. 1994 Nov 3-6;6:275 (unnumbered poster).
       Unique Identifier : AIDSLINE ASHM6/95291850
 AB    A 38 year old homosexual male infected with the Human Immunodeficiency
       Virus developed severe right upper quadrant pain in May 1993
       necessitating admission to hospital. Examination revealed marked right
       upper quadrant tenderness. Ultrasound examination demonstrated marked
       tenderness over the liver but no gallstones were seen. Investigations
       showed a normal white cell count, an ESR of 5mm/hr, a C-reactive protein
       of 36 (N < 10) and mildly abnormal liver function tests. His CD4
       lymphocyte count was 530. Abdominal CT scan was normal. Five days later
       he developed prostatitis and needed a catheter for urinary retention. He
       had no fever at any stage. Ciprofloxacin and doxycycline were given for
       21 days. Pain remained a major feature and he required regular
       pethidine. Twenty-one days after commencing antibiotics his pain settled
       and he felt well. A serological diagnosis of recent chlamydial
       trachomatis infection was made with a positive IgM and a > 4 fold rise
       in IgG. Chlamydial cultures were not done. One month later the patient
       relapsed and was again treated with a long (26 days) course of
       antibiotics (roxithromycin, rifampicin, trimethoprim). Again, the pain
       was slow to settle but he made a full recovery. In July he again
       relapsed with abdominal pain which again settled with antibiotics. In
       April 1994 he again relapsed but with lower abdominal pain. Laparoscopy
       at this stage revealed no cause for his lower abdominal pain but
       revealed old perihepatic scarring and adhesions from the chlamydia. C.
       trachomatis serology revealed no IgM and low levels of IgG. This is the
       first reported case of Chlamydia trachomatis Fitz-Hugh Curtis Syndrome
       in a male. Fitz-Hugh Curtis Syndrome should be considered in the
       differential diagnosis of acalculous cholecystitis.
 DE    Adult  AIDS-Related Opportunistic Infections/*DIAGNOSIS  Case Report
       *Chlamydia trachomatis  Chlamydia Infections/*DIAGNOSIS
       Cholecystitis/*DIAGNOSIS  Diagnosis, Differential  Homosexuality, Male
       Human  Male  Prostatitis/DIAGNOSIS  Recurrence  MEETING ABSTRACT

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