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Chlamydia Trachomatis Peritonitis: Report Of A Patient Presenting Spontaneous Regression Of Ascites

Yanagisawa et al., 1992Other/Unknown

Yanagisawa, N., Tomiyasu, H., Hada, T., Kure, N., Kobayashi, Y., Katamoto, T., Sugaya, H., & Harada, T. (1992). Chlamydia trachomatis peritonitis: report of a patient presenting spontaneous regression of ascites. Internal medicine (Tokyo, Japan), 31(6), 835–839. https://doi.org/10.2169/internalmedicine.31.835

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Abstract

A 36-year-old Japanese woman complained of right hypochondralgia followed by ascites. Paracentesis showed a turbid, straw-colored sterile exudate. Computed tomography and magnetic resonance imaging of the abdomen revealed a left periuteric mass and ascites. The mass and ascites spontaneously regressed within a month with no specific treatment. Later, after the patient had been discharged from hospital, immunofluorescence antibody titers for Chlamydia trachomatis were successfully determined using stored ascitic fluid and serum. Though the number of cases of Chlamydia trachomatis peritonitis has increased, few cases with ascites have been reported, and spontaneous regression of the ascites is also rare.

Case Details

Disease Location

Peritoneum/uterus

Personal Characteristics

36-year-old japanese office woman. No remarkable medical history. No familial disease, no blood transfusion history.

Clinical Characteristics

Clear vaignal discharge after her last menstruation in april. Then the discharge increased and became off-coleres; she felt sahrp pain in the right inguinal area. She had not had sexual intercourse in previous las five months. Right inguinal pain migrated to the right hypochondrium. Abdominal us demonstrated a cervical polyp. Her symptoms improve after oral administration of antipholigistics. 2 months later she complaint of fullness sensation in the lower abdomen and 3kg weight loss in the last 6 weeks. Pe revealed slight tenderness in the rh and ascites. Laboratory data showed slight anemia and, positive apr, ca125 was slightly elevated. CT showed moderate ascites and a mass in the left side of the uterus, it was isodense. MRI revealed an area of slightly low signal intensity on the t1 sequence. Ascites decrease gradually.

Remission Characteristics

After that, tumour markers decreased and the mass was no longer detectable on MRI. Peritoneal fluid was positive for c. Trachomatis.

Treatment & Mechanisms

Proposed Remission Mechanisms

No info

Clinical Treatment

Oral administration of antipholigistics. Erythromycin