Amoebic liver abscess

Amoebic_liver_abscess

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  Liver containing amebic abscess, gross pathology

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  First case of amebic liver abscess 22 years after the first occurrence

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  Role of neutrophils in rodent amebic liver abscess

Amoebic Liver Abscess

An amoebic liver abscess is a collection of pus in the liver in response to infection by the parasite Entamoeba histolytica. This condition is a severe complication of amoebiasis, which primarily affects the gastrointestinal tract.

Pathophysiology

Entamoeba histolytica is a protozoan parasite that primarily causes amoebic dysentery and colitis. The organism can invade the intestinal wall and spread via the portal vein to the liver, where it can cause an abscess. The abscess is typically filled with necrotic tissue and inflammatory cells, and it is often described as having a "chocolate sauce" appearance due to its color and consistency.

Clinical Presentation

Patients with an amoebic liver abscess often present with fever, right upper quadrant pain, and hepatomegaly. Other symptoms may include jaundice, anorexia, and weight loss. The onset of symptoms can be acute or insidious.

Diagnosis

The diagnosis of an amoebic liver abscess is based on clinical suspicion, imaging studies, and serological tests. Ultrasound and CT scan of the abdomen can reveal the presence of an abscess in the liver. Serological tests can detect antibodies against Entamoeba histolytica and are useful in confirming the diagnosis.

Treatment

The primary treatment for an amoebic liver abscess is antimicrobial therapy. Metronidazole is the drug of choice and is effective in killing the trophozoites of Entamoeba histolytica. In some cases, aspiration of the abscess may be necessary, especially if there is a risk of rupture or if the abscess is not responding to medical therapy.

Complications

Complications of an amoebic liver abscess can include rupture into the peritoneal cavity, pleural cavity, or pericardium, leading to peritonitis, pleural effusion, or pericarditis, respectively. These complications can be life-threatening and require prompt medical intervention.

Prevention

Preventive measures include improving sanitation and hygiene to reduce the transmission of Entamoeba histolytica. This includes ensuring access to clean water, proper disposal of human waste, and educating the public about the importance of handwashing and food safety.

Related Pages

• Amoebiasis
• Entamoeba histolytica
• Liver abscess
• Metronidazole