Fitz-Hugh-Curtis Syndrome: Causes, Symptoms, and Treatment
Written by Achuta Uppu, MD. Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Fitz-Hugh-Curtis syndrome?
Fitz-Hugh-Curtis syndrome, inflammation around the liver linked to a pelvic infection, is managed together by a gynecologist (women's health doctor) and an infectious disease doctor. A primary care doctor can also help coordinate testing and treatment. Treatment focuses on clearing the underlying infection.
What is Fitz-Hugh-Curtis syndrome?
Fitz-Hugh-Curtis syndrome is a rare disorder that occurs almost exclusively in women. It causes swelling and irritation, called inflammation, in the tissues around the liver.
It is a complication of pelvic inflammatory disease (PID). PID is an infection of a woman's reproductive organs. In this syndrome, string-like bands of scar tissue form between the liver and the belly wall or the diaphragm. These bands are called adhesions. The diaphragm is a muscle that helps you breathe.
Symptoms
The main symptom is pain in the upper right part of the belly. The pain can start suddenly. Movement often makes it worse. Other symptoms can include:
- Pain that spreads to the right shoulder and the inside of the right arm.
- Fever and chills.
- Night sweats.
- Nausea and vomiting.
- Headache and hiccups.
Some people also have signs of PID. These include fever, vaginal discharge, and lower belly pain. PID can also cause mild symptoms or none at all.
Causes and who gets it
Most cases are caused by the bacteria that cause chlamydia or gonorrhea. Both infections spread through sex. Chlamydia causes more cases than gonorrhea, researchers believe. Doctors do not fully understand how these infections lead to the syndrome.
Most cases occur in women of childbearing age who have PID. About 4 to 14 percent of women with PID develop Fitz-Hugh-Curtis syndrome. It happens more often in teens with PID. In extremely rare cases, it has occurred in men.
You are more likely to get PID if you have had PID before or have a sexually transmitted infection that was not treated.
How doctors diagnose it
Doctors diagnose this syndrome by ruling out other causes of upper right belly pain. Other problems can look alike. Examples are hepatitis, gallbladder swelling, and appendicitis.
Imaging tests can rule out other problems or show swelling around the liver. These include ultrasound, X-rays, and CT scans. Lab tests can find the bacteria that cause chlamydia or gonorrhea. A doctor may also do a laparoscopy. A thin tube goes into the belly through a small cut. It lets the doctor see the liver.
Treatment
Antibiotics are the main treatment. They are medicines that fight the infection that started the problem. Doctors may choose from several antibiotics. Pain medicines may also be used in some cases.
If you take antibiotics for PID, take all of the medicine, even if your symptoms go away. Tell your recent sex partners so they can get tested and treated. Do not have sex until you finish treatment. Treatment cannot fix permanent damage that PID has already done.
Sometimes antibiotics do not relieve the symptoms. In that case, a doctor may do a surgery to destroy the scar tissue around the liver.
When to see a doctor
See a doctor if you have pain in the upper right belly. Also see a doctor for signs of PID, such as lower belly pain, fever, or vaginal discharge with a bad smell. See a doctor promptly if you think you or your partner may have caught a sexually transmitted infection. Early treatment is important. Waiting too long to treat PID raises the risk of infertility, which means trouble getting pregnant.
Call 911 or go to the emergency room if you have severe belly pain or pressure, trouble breathing, or fainting. Also go if you suddenly become confused.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can examine you and order tests. They can also help coordinate your care with specialists.
Common questions
What causes Fitz-Hugh-Curtis syndrome?
Fitz-Hugh-Curtis syndrome is a complication of pelvic inflammatory disease (PID), an infection of a woman's reproductive organs. Most cases are caused by the bacteria that cause chlamydia or gonorrhea, and untreated sexually transmitted infections can lead to PID.
Can a direct primary care doctor manage Fitz-Hugh-Curtis syndrome?
A direct primary care doctor can start testing for the underlying infection and begin initial treatment, then refer you to a gynecologist or infectious disease doctor when needed.
How quickly can I be seen for Fitz-Hugh-Curtis syndrome?
Because it involves an underlying infection that can worsen if untreated, you should be seen soon. How fast you can be seen depends on the office you choose, so call the office before you book to ask about openings.
Sources
- NORD - Fitz Hugh Curtis Syndrome
- MedlinePlus - Pelvic Inflammatory Disease
- CDC - About Pelvic Inflammatory Disease (PID)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
