Fitz-Hugh-Curtis syndrome (FCS) is a condition in which bacteria (usually cased by Gonorrhoea of Chlamydia bacteria), usually from a pelvic infection, spread through the abdomen and cause inflammation of the tissue surrounding the liver. It mostly occurs in women with Pelvic Inflammatory Disease (PID), but may also occur in women without PID, and in men.


The cause is not clearly understood. It may be caused by multiple unrelated sources such as virus infection, stress, and toxins.


  • Severe pain in the upper right part of the abdomen and movement of pain to right shoulder. Sometimes the pain increases with coughing, sneezing, or movement.
  • Since the source of FCS is most often a pelvic infection, symptoms such as nausea, vomiting, chills, fever, and headaches may be present.
  • unbearable fatigue lasting greater than 6 months
  • Post-exertional malaise lasting more than 24 hours (relapse of symptoms after physical or mental exertion)
  • Un refreshing sleep
  • Substantial impairment in memory or concentration
  • Persistent muscle pain
  • Pain in multiple joints without swelling or redness
  • Headaches of a new type, pattern, or severity
  • Sore throat
  • Tender neck or armpit lymph nodes


The presence of FCS is invisible in general, so upper abdominal pain may suggest the diagnosis. The presence of a pelvic infection would also provide a clue to the diagnosis, but without PID the diagnosis may be difficult, since many conditions can cause abdominal pain. If two particular pelvic infections, chlamydia and gonorrhea are present, the white blood cell count (WBC) in the blood will be high, as resolve the erythrocyte sedimentation rate (ESR).

The physician will examine the individual for common conditions which have symptoms similar to FCS, such as gallstones, liver inflammation (hepatitis), kidney stones or infection, and stomach ulcer. Abdominal ultrasound and computed tomography (CT) scan can help rule out these disorders. A chest x-ray can rule out pneumonia as a cause of pain with coughing or sneezing.

Since chlamydia and gonorrhea are spread through sexual contact, the individual must restrict her/his sexual activity until the infection is gone, and the individual’s sexual partner(s) must also be treated.