BACKGROUND: Fitz-Hugh-Curtis syndrome or acute perihepatitis is considered a 
rare complication of pelvic inflammatory disease, mostly associated with 
chlamydial or gonococcal salpingitis. Peritoneal tuberculosis is a rare site of 
extra-pulmonary infection caused by Mycobacterium tuberculosis. Infection 
usually occurs after reactivation of latent tuberculous foci in the peritoneum 
and more seldom after contiguous spread from tuberculous salpingitis.
CASE PRESENTATION: We describe a case of a 21-year old female of Somalian origin 
diagnosed with Fitz-Hugh Curtis syndrome associated with tuberculous salpingitis 
and peritonitis, presenting with new onset ascites. Acid fast stained smear and 
polymerase chain reaction for Mycobacterium tuberculosis on ascitic fluid, 
endocervical culture and tuberculin skin test were all negative. Eventually, the 
diagnosis was made laparoscopically, showing multiple peritoneal white nodules 
and perihepatic "violin string" fibrinous strands.
CONCLUSIONS: To our knowledge, this is the first case where Fitz-Hugh-Curtis 
syndrome is associated with both peritoneal and genital tuberculosis and where 
ascites was the primary clinical finding. Female genital tuberculosis has only 
rarely been associated with Fitz-Hugh-Curtis syndrome and all cases presented 
with chronic abdominal pain and/or infertility. Ascites and peritoneal 
involvement was not present in any case. Moreover, most patients with 
Fitz-Hugh-Curtis syndrome show no evidence of generalized intra-abdominal 
infection and only occasionally have concomitant ascites.