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Case Rep Obstet Gynecol. 2016;2016:8547173. Epub 2016 Sep 25.

Chlamydia Peritonitis and Ascites Mimicking Ovarian Cancer.

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Department of Obstetrics and Gynecology, Jamaica Hospital Medical Center, Jamaica, NY 11418, USA.
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Stanford University Hospital and Clinics, Stanford, CA 94305, USA.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, UCLA, Los Angeles, CA 94305, USA.
Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06510, USA.


Background. Pelvic inflammatory disease (PID) rarely results in diffuse ascites. Severe adhesive disease secondary to PID may lead to the formation of inclusion cysts and even pelvic peritoneal nodularity due to postinflammatory scarring and cause an elevation of serum CA-125 levels. The constellation of these findings may mimic an ovarian neoplasm. Case. We report a case of a 22-year-old female who presented with multiple pelvic cysts and diffuse ascites due to Chlamydia trachomatis infection. The initial gynecologic exam did not reveal obvious evidence of PID; however, a positive Chlamydia trachomatis test, pathologic findings, and the exclusion of other etiologies facilitated the diagnosis. Conclusion. Chlamydia trachomatis and other infectious agents should be considered in the differential diagnosis of a young sexually active female with abdominal pain, ascites, and pelvic cystic masses. Thorough workup in such a population may reduce the number of more invasive procedures as well as unnecessary repeat surgical procedures.

Conflict of interest statement

The authors declare no competing interests or previous publication and fulfill all conditions required for authorship.

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