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Azrielant S, Sheffy A, Kanani F, Nissan I, Adler A, Dekel M. Mpox proctitis as a likely predisposing factor for chlamydial perihepatitis in a male patient. Sex Transm Infect 2023; 99:287-288. [PMID: 36882313 DOI: 10.1136/sextrans-2023-055757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/10/2023] [Indexed: 03/09/2023] Open
Abstract
Perihepatitis (Fitz-Hugh-Curtis syndrome) is a rare complication of sexually transmitted infections, mostly seen in women. Only 12 male cases have been reported to date, of which Chlamydia trachomatis was confirmed in 2. We report a case of chlamydial perihepatitis in a male patient, occurring 1 month after Mpox and associated with the unusual LGV ST23 strain. Our case suggests that rectal Mpox lesions may facilitate chlamydial dissemination.
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Affiliation(s)
- Shir Azrielant
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Amichai Sheffy
- Emergency Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Fahim Kanani
- General Surgery Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Israel Nissan
- Public Health Services, Ministry of Health, National Public Health Laboratory, Tel Aviv, Israel
| | - Amos Adler
- Clinical Microbiology Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Dekel
- Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Iwadare T, Kimura T, Nagata Y, Suzuki H, Kunimoto H, Kitabatake H, Seki A, Ochi Y, Hara E, Umemura T. A case of malignant peritoneal mesothelioma with a Fitz-Hugh-Curtis syndrome-like imaging finding. Clin J Gastroenterol 2023; 16:372-376. [PMID: 36781827 DOI: 10.1007/s12328-023-01770-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/03/2023] [Indexed: 02/15/2023]
Abstract
Malignant peritoneal mesothelioma (MPeM) is a rare disease with a poor prognosis that develops in the mesothelial cells of the peritoneum. We encountered a 48-year-old man with no prior asbestos exposure who visited our hospital with abdominal pain. Laboratory findings showed elevated C-reactive protein of 15.5 mg/dL. Contrast-enhanced computed tomography (CT) detected a Fitz-Hugh-Curtis syndrome-like contrast effect on the liver surface and thickening of the peritoneum. Blood culture, Mycobacterium tuberculosis-specific IFN-γ release assay, Chlamydia trachomatis and Neisseria gonorrhoeae DNA testing, and antinuclear antibody were all negative. CA125 was high at 124.8 U/mL. The laparoscopy for diagnostic purposes revealed adhesions between the liver surface and peritoneum in addition to numerous small and large white nodules on the peritoneum. Biopsy of the nodules confirmed the diagnosis of epithelial-type MPeM. Treatment was initiated with combined cisplatin and pemetrexed, and CT 6 months later showed a reduced contrast effect on the liver surface and improved peritoneal thickening. A Fitz-Hugh-Curtis syndrome-like contrast effect on the liver surface on contrast-enhanced CT may help identify MPeM.
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Affiliation(s)
- Takanobu Iwadare
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.,Department of Gastroenterology, Nagano Municipal Hospital, 1333-1 Tomitake, Nagano, 381-8551, Japan
| | - Takefumi Kimura
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan. .,Consultation Center for Liver Diseases, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
| | - Yusuke Nagata
- Department of Gastroenterology, Nagano Municipal Hospital, 1333-1 Tomitake, Nagano, 381-8551, Japan
| | - Hiroshi Suzuki
- Department of Gastroenterology, Nagano Municipal Hospital, 1333-1 Tomitake, Nagano, 381-8551, Japan
| | - Hideo Kunimoto
- Department of Gastroenterology, Nagano Municipal Hospital, 1333-1 Tomitake, Nagano, 381-8551, Japan
| | - Hiroyuki Kitabatake
- Department of Gastroenterology, Nagano Municipal Hospital, 1333-1 Tomitake, Nagano, 381-8551, Japan
| | - Ayako Seki
- Department of Gastroenterology, Nagano Municipal Hospital, 1333-1 Tomitake, Nagano, 381-8551, Japan
| | - Yasuhide Ochi
- Department of Gastroenterology, Nagano Municipal Hospital, 1333-1 Tomitake, Nagano, 381-8551, Japan
| | - Etsuo Hara
- Department of Gastroenterology, Nagano Municipal Hospital, 1333-1 Tomitake, Nagano, 381-8551, Japan
| | - Takeji Umemura
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.,Consultation Center for Liver Diseases, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, 390-8621, Japan
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Antonik M, Ovens KJ, Labib PL, Briggs CD. Chlamydia (lymphogranuloma venereum) peritonitis in a male patient. BMJ Case Rep 2021; 14:14/4/e240526. [PMID: 33853816 PMCID: PMC8054041 DOI: 10.1136/bcr-2020-240526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 49-year-old man presented with a 1-week history of abdominal pain, distension, diarrhoea and fatigue. CT of the abdomen and pelvis revealed peritonitis with no identifiable cause. Diagnostic laparoscopy was performed, which excluded gastrointestinal perforation. Peritoneal fluid tested positive for Chlamydia trachomatis and rectal swabs were positive for C. trachomatis serovars consistent with lymphogranuloma venereum (LGV). Additional blood tests also revealed a diagnosis of syphilis. This is a rare documented case of LGV peritonitis in a male without associated immunodeficiency. The patient recovered well following laparoscopic washout and a course of appropriate antibiotics.
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Affiliation(s)
- Magdalena Antonik
- Department of General Surgery, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Katie J Ovens
- Sexual Health in Plymouth, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Peter L Labib
- Department of General Surgery, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Christopher D Briggs
- Department of General Surgery, University Hospitals Plymouth NHS Trust, Plymouth, UK
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