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Chlamydia ascites: a call for sexually transmitted infection testing
  1. Brittne Halford,
  2. Mariah Barstow Piazza,
  3. David Liu and
  4. Chuma Obineme
  1. Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
  1. Correspondence to Dr Brittne Halford, Brittne.Halford{at}


A 26-year-old gravida 2, para 2-0-0-2 woman with a recent uncomplicated vaginal delivery 10 weeks prior presented to our hospital with 5 weeks of abdominal swelling and discomfort. Four weeks after delivery, the patient began having right upper quadrant pain and was found to have cholelithiasis. She underwent an elective laparoscopic cholecystectomy 6 weeks prior to admission, but started to develop worsening abdominal swelling 1 week postoperatively. Abdominal distension and shifting dullness were present on examination. CT of the abdomen and pelvis was remarkable for moderate-volume ascites and mild enhancement of the pelvic peritoneum. Paracentesis removed 2.46 L of ascites fluid with 76% lymphocytic predominance. Results for Chlamydia trachomatis were positive in urine, cervical swab and ascitic fluid. Doxycycline was prescribed for a diagnosis of pelvic inflammatory disease exudative ascites. Since discharge, she has completed her antibiotic course and reports resolution of all symptoms without recurrence of ascites.

  • infection (gastroenterology)
  • general practice / family medicine
  • infectious diseases
  • obstetrics and gynaecology
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  • Contributors All authors contributed to the care of the patient and writing the case report. BH reviewed, revised and submitted the case report and serves as the corresponding author.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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