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Clinical features and management of amebic liver abscess. Experience from 29 patients

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Summary

29 patients with amebic liver abscess were evaluated in a study to examine clinical picture, laboratory data, epidemiology, radiologic methods, and therapy. Since the clinical picture was unspecific a considerable amount of misdiagnoses occurred, and often originated from pulmonary symptoms. To establish diagnosis one should rely on the triad with positive amebic serology, intrahepatic scanning defects, and clinical picture with fever, right upper quadrant pain, and hepatomegaly. Nearly all patients had an exposure history of travel or immigration from endemic areas in the tropics. Medical therapy with metronidazole alone is highly effective and leads to defervescence and clinical improvement usually within 3–5 days. Invasive procedures, such as needle aspiration or surgical drainage of the abscess are rarely needed; these invasive methods neither shorten the course of the disease nor improve prognosis.

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Abbreviations

E. histolytica:

Entamoeba histolytica

ALA:

Amebic liver abscess

ESR:

Erythrocyte sedimentation rate

References

  1. Abuabara SF, Barrett JA, Hau T, Jonasson O (1982) Amebic liver abscess. Arch Surg 117:239–244

    Google Scholar 

  2. Adams EB, MacLeod IN (1977) Invasive amebiasis II. Amebic liver abscess and its complications. Medicine 56:325–334

    Google Scholar 

  3. Aikat BK, Bhusnurmath SR, Pal AK, Chhuttani PN, Datta DV (1979) The pathology and pathogenesis of fatal hepatic amoebiasis — a study based on 79 autopsy cases. Trans Roy Soc Trop Med Hyg 73:188–192

    Google Scholar 

  4. Allason-Jones E, Mindel A, Sargeaunt P, Williams P (1986) Entamoeba histolytica as a commensal intestinal parasite in homosexual men. N Engl J Med 315:353–356

    Google Scholar 

  5. Atlason-Jones E, Mindel A, Sargeaunt P, Katz D (1988) Outcome of untreated infection with Entamoeba histolytica in homosexual men with and without HIV antibody. Br Med J 297:654–657

    Google Scholar 

  6. Balasegaram M (1981) Management of hepatic abscess. Curr Probl Surg 18:284–340

    Google Scholar 

  7. Basile JA, Klein SR, Worthen NJ, Wilson SE, Hiatt JR (1983) Amebic liver abscess — The surgeon's role in management. Am J Surg 146:67–71

    Google Scholar 

  8. Bienzle U, Coester CH, Knobloch J, Guggenmoos-Holzmann I (1984) Protozoal enteric infections in homosexual men. Klin Wochenschr 62:323–327

    Google Scholar 

  9. Brumpt E (1925) Etude sommaire de l' “Entamoeba dispar” u. Sp. Amibe á Kystes quadrinucléés, parasite de l'homme. Bull Acad Med 94:943–952

    Google Scholar 

  10. Conter RL, Pitt HA, Tompkins RK, Longmire WP (1986) Differentiation of pyogenic from amebic hepatic abscesses. Surg Gynecol Obstet 162:114–120

    Google Scholar 

  11. Crane PS, T'ae Lee Y, Seel DJ (1972) Experience in the treatment of two hundred patients with amebic abscess of the liver in Korea. Am J Surg 123:332–337

    Google Scholar 

  12. Eggleston FC, Verghese M, Handa AK, Gill SS (1978) The result of surgery in amebic liver abscess: Experiences in eighty-three patients. Surgery 83:536–539

    Google Scholar 

  13. Goldmeier D, Price AB, Billington O, Borriello P, Shaw A, Sargeaunt P, Munday PE, Dixon I, Carder JM, Hilten J (1986) Is Entamoeba histolytica in homosexual men a pathogen? Lancet I:641–644

    Google Scholar 

  14. Greenstein AJ, Barth J, Dicker A, Bottone EJ, Aufses AH (1985) Amebic liver abscess: a study of 11 cases compared with a series of 38 patients with pyogenic liver abscess. Am J Gastroent 80:472–478

    Google Scholar 

  15. Griffin FM (1973) Failure of metronidazole to cure hepatic abscess. N Engl J Med 288:1397

    Google Scholar 

  16. Harrison RH, Crane CP, Fulginitis VA (1979) Amebic liver abscess in children: clinical and epidemiologic features. Pediatrics 64:923–928

    Google Scholar 

  17. Ibarra-Pérez C (1981) Thoracic complications of amebic abscess of the liver. Chest 79:672–677

    Google Scholar 

  18. Jackson TFHG, Gathiram V (1985) Seroepidemiological study of antibody responses to the zymodemes of Entamoeba histolytica. Lancet I:716–719

    Google Scholar 

  19. Jenkinson SG, Hargrove MD (1975) Recurrent amebic abscess of the liver. JAMA 232:277

    Google Scholar 

  20. Katzenstein D, Rickerson V, Braude A (1982) New concepts of amebic liver abscess derived from hepatic imaging, serodiagnosis, and hepatic enzymes in 67 consecutive cases in San Diego. Medicine 61:237–246

    Google Scholar 

  21. Knobloch J, Mannweiler E (1983) Development and persistence of antibodies to Entamoeba histolytica in patients with amebic liver abscess. Am J Trop Med Hyg 32:727–732

    Google Scholar 

  22. Mathews HM, Moss DM, Healy GR, Mildvan D (1986) Isoenzyme analysis of Entamoeba histolytica isolated from homosexual men. J Inf Dis 153:793–795

    Google Scholar 

  23. Patterson M, Schoppe LE (1982) The presentation of amoebiasis. Med Clin N Am 66:689–705

    Google Scholar 

  24. Peters M, Dietrich M, Bienzle U, Kern P, Mannweiler E (1979) Amoebic liver abscess: a retrospective clinical evaluation of twenty-seven cases. Tropenmed Parasit. 30:409–416

    Google Scholar 

  25. Proctor EM, Wong Q, Yang J, Keystone JS (1987) The electrophoretic isoenzyme patterns of strains of Entamoeba histolytica isolated in two major cities in Canada. Am J Trop Med Hyg 37:296–301

    Google Scholar 

  26. Ralls PW, Barnes PF, Johnson MB, De Cock KM, Radin DR, Halls J (1987) Medical treatment of hepatic amebic abscess: rare need for percutaneous drainage. Radiology 165:805–807

    Google Scholar 

  27. Sargeaunt P, Jackson TFHG, Simjee A (1982) Biochemical homogeneity of Entamoeba histolytica isolates, especially those from liver abscess. Lancet I:1386–1388

    Google Scholar 

  28. Sargeaunt P, Baveja UK, Nanda R, Anand BS (1984) Influence of geographical factors in the distribution of pathogenic zymodemes of Entamoeba histolytica: identification of zymodeme XIV in India. Trans Roy Soc Trop Med Hyg 78:96–101

    Google Scholar 

  29. Sargeaunt P (1987) The reliability of Entamoeba histolytica zymodemes in clinical diagnosis. Parasitology today 3:40–43

    Google Scholar 

  30. Shabot JM, Patterson M (1978) Amebic liver abscess: 1966–1976. Dig Dis 23:110–118

    Google Scholar 

  31. Sheehy TW, Parmely LF, Johnston GS, Boyce HW (1968) Resolution time of an amebic liver abscess. Gastroenterology 55:26–34

    Google Scholar 

  32. van Sonnenberg E, Mueller PR, Schiffman HR, Ferrucci JT, Casola G, Simeone JF, Cabrera OA, Gosink BB (1985) Intrahepatic amebic abscesses: indications for and results of percutaneous catheter drainage. Radiology 156:631–635

    Google Scholar 

  33. Thompson JE, Forlenz S, Verma R (1985) Amebic liver abscess: a therapeutic approach. Rev Inf Dis 7:171–179

    Google Scholar 

  34. Walsh JA (1986) Problems in recognition and diagnosis of amebiasis: estimation of the global magnitude of morbidity and mortality. Rev Inf Dis 8:228–238

    Google Scholar 

  35. Weinke Th, Friedrich-Jänicke B, Lichy S, Janitschke K (1987) Isoenzyme patterns of Entamoeba histolytica isolated from homosexual men. Trop Med Parasit 38:337–338

    Google Scholar 

  36. Weinke Th, Lichy S, Janitschke K, Friedrich-Jänicke B (1988) Isoenzymbestimmungen bei monoxenisch gezüchteten Stämmen von Entamoeba histolytica. Mitt Österr Ges Tropenmed Parasitol 10:175–182

    Google Scholar 

  37. Weinke Th, Friedrich-Jänicke B, Sargeaunt P, Trautmann M, Janitschke K (1988) Amebic liver abscess in a European patient: zymodeme classification of Entamoeba histolytica. Klin Wochenschr 66:37–40

    Google Scholar 

  38. Weinke Th, Friedrich-Jänicke B, Janitschke K (1988) Bedeutung von Entamoeba histolytica bei Tropenrückkehrern. Dtsch Med Wschr 113:678–682

    Google Scholar 

  39. World Health Organization (1985) Amebiasis and its control. Bull World Health Organiz 63:417–426

    Google Scholar 

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Weinke, T., Scherer, W., Neuber, U. et al. Clinical features and management of amebic liver abscess. Experience from 29 patients. Klin Wochenschr 67, 415–420 (1989). https://doi.org/10.1007/BF01725136

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  • DOI: https://doi.org/10.1007/BF01725136

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