Amoebic hepatic abscess
Gross pathology of liver containing amoebic abscess
SpecialtyInfectious diseases Edit this on Wikidata

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 abscess' commonly present as right upper quadrant abdominal pain and fever, with worsening features associated with abscess rupture.[2]

Magnetic resonance cholangiopancreatography (MRC) image showing a voluminous and heterogeneous collection in the left liver lobe (amoebic abscess)

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]

Treatment

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

Research

Role of neutrophils in rodent amebic liver abscess [4]

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

  1. ↑ 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. ISSN 1776-1042. PMC 4472968. PMID 26088504.Open access icon
  2. 1 2 3 4 Wuerz, T; Kane, JB; Boggild, AK; Krajden, S; Keystone, JS; Fuksa, M; Kain, KC; Warren, R; Kempston, J; Anderson, J (October 2012). "A review of amoebic liver abscess for clinicians in a nonendemic setting". Canadian Journal of Gastroenterology. 26 (10): 729–33. doi:10.1155/2012/852835. PMC 3472914. PMID 23061067.
  3. ↑ Harrison's Principles of Internal Medicine (20 ed.). Mc Graw Hill. p. 402. ISBN 978-1-26-045535-9.
  4. 1 2 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. ISSN 1776-1042. PMC 4754534. PMID 26880421.
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