What is the first line treatment approach for Fitz-Hugh-Curtis Syndrome?

Fitz-Hugh-Curtis Syndrome is characterized by the inflammation of the liver capsule and is often associated with pelvic inflammatory disease (PID), particularly caused by sexually transmitted infections such as gonorrhea and chlamydia. The first line treatment approach involves addressing both the infection and any associated pelvic inflammation.

The combination of ceftriaxone, doxycycline, and metronidazole is effective because it covers a broad spectrum of possible pathogens. Ceftriaxone is a third-generation cephalosporin that is particularly effective against Neisseria gonorrhoeae, a common bacterial agent in cases of PID. Doxycycline provides coverage for Chlamydia trachomatis, another leading cause of PID and associated inflammatory conditions. Metronidazole adds anaerobic coverage, which is crucial given the polymicrobial nature of infections in the pelvic region.

This combination therapy effectively treats the underlying infections that could contribute to Fitz-Hugh-Curtis Syndrome, reducing the risk of complications and promoting recovery. The use of supportive therapy alone would not adequately address the infectious etiology of the syndrome, nor would antiviral treatments like oral acyclovir, which are primarily used for viral infections. Meropenem, while a broad-spectrum carbapenem antibiotic, is