PID Complications: Liver Involvement Explained

Fitz-Hugh–Curtis Syndrome – The PID Complication That Climbs to the Liver A young woman

with pelvic inflammatory disease develops sharp right upper quadrant pain, yet her liver

enzymes are as normal as your premed attendance record. Chlamydia trachomatis or Neisseria gonorrhoeae travel

across the peritoneum to the liver capsule, creating “violin-string” adhesions between the liver

and abdominal wall. Diagnosis: RUQ pain + PID + normal hepatobiliary labs,

with the gallbladder completely innocent. Treat PID with ceftriaxone plus doxycycline; add metronidazole if

anaerobes join the party. Admit if severe, pregnant, or diagnosis is

unclear. Miss this, and your differential will be more out of tune