Advanced peritonitis and subclinical disseminated intravascular coagulopathy associated with Chlamydia trachomatis infection.

A 29-y-old woman was admitted to our hospital complaining of slight fullness of the lower abdomen. Ultrasound echographic study and magnetic resonance imaging showed pleural effusion and pelvic ascites. Laboratory investigation revealed anemia and thrombocytopenia (hemoglobin 6 mmol/l; platelets 7 x 10(10)/l), remarkable polyclonal hypergammopathy (gamma immunoglobulin 7.7 g/dl) and subclinical disseminated intravascular coagulopathy (DIC). By laparoscopy, extensive adhesion of the peritoneum and bilateral ovarian tubes was observed. From the appearance of adhesion, we suspected Chlamydia trachomatis infection and performed serologic and molecular studies. Administration of clarithromycin resolved hypergammopathy, DIC and ascites.