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Amoebic hepatic abscess
Amoebic hepatic abscess
	Gross pathology of liver containing amoebic abscess
Specialty	Infectious diseases

A amoebic liver abscess is a type of liver abscess caused by amebiasis.^[1] It is the involvement of liver tissue by trophozoites of the organism Entamoeba histolytica and of its abscess due to necrosis.

Presentation

Approximately 90% of patients with E histolytica are asymptomatic.^[2] The two most common manifestations of E histolytica include colitis (bloody stool with mucus, abdominal pain, and/or diarrhea), and discovery of a liver abscess on imaging.^[2] Liver abscesses commonly present as right upper quadrant abdominal pain and fever, with worsening features associated with abscess rupture.^[2]

Symptoms

Pain right hypochondrium referred to the right shoulder
Pyrexia (100.4 F)
Profuse sweating and rigors
Loss of weight
Earthy complexion

Signs

Pallor
Tenderness and rigidity in right hypochondrium
Palpable liver
Intercostal tenderness
Basal lung signs

Diagnosis

Diagnosis is primarily made by identifying stool ova and parasites on stool antigen testing in the presence of colitis, or E histolytica serology.^[2]

Blood ceruloplasmin
Haemoglobin estimation
Stools examination (trophozoites and cysts)
Radiography
Aspiration exploratory
Medical ultrasonography and CT scanning
Sigmoidoscopy
Liver function tests
Serological tests

Treatment

Although medical management using long courses of antibiotics have proven to be successful, Drainage of the abscess is the mainstay treatment. ^[3]

Research

Due to the difficulty of exploring host and amebic factors involved in the pathogenesis of amebic liver abscess in humans, most studies have been conducted with animal models (e.g., mice, gerbils, and hamsters). Histopathological findings revealed that the chronic phase of amebic liver abscess in humans corresponds to lytic or liquefactive necrosis, whereas in rodent models there is granulomatous inflammation. However, the use of animal models has provided important information on molecules and mechanisms of the host/parasite interaction in amebic liver abscess.^[4]

References

^ Nespola, Benoît; Betz, Valérie; Brunet, Julie; Gagnard, Jean-Charles; Krummel, Yves; Hansmann, Yves; Hannedouche, Thierry; Christmann, Daniel; Pfaff, Alexander W.; Filisetti, Denis; Pesson, Bernard; Abou-Bacar, Ahmed; Candolfi, Ermanno (2015). "First case of amebic liver abscess 22 years after the first occurrence". Parasite. 22: 20. doi:10.1051/parasite/2015020. PMC 4472968. PMID 26088504.
^ ^a ^b ^c ^d Wuerz, Terry; Kane, Jennifer B; Boggild, Andrea K; Krajden, Sigmund; Keystone, Jay S; Fuksa, Milan; Kain, Kevin C; Warren, Ralph; Kempston, John; Anderson, Joe (2012). "A Review of Amoebic Liver Abscess for Clinicians in a Nonendemic Setting". Canadian Journal of Gastroenterology. 26 (10): 729–733. doi:10.1155/2012/852835. PMC 3472914. PMID 23061067.
^ Harrison's Principles of Internal Medicine (20 ed.). Mc Graw Hill. 22 October 2019. p. 402. ISBN 978-1-26-045535-9.
^ ^a ^b Campos-Rodríguez, Rafael; Gutiérrez-Meza, Manuel; Jarillo-Luna, Rosa Adriana; Drago-Serrano, María Elisa; Abarca-Rojano, Edgar; Ventura-Juárez, Javier; Cárdenas-Jaramillo, Luz María; Pacheco-Yepez, Judith (2016). "A review of the proposed role of neutrophils in rodent amebic liver abscess models". Parasite. 23: 6. doi:10.1051/parasite/2016006. PMC 4754534. PMID 26880421.