Amoebic Liver Abscess

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Clinical Description

Amoebic liver abscess is a collection of typically brownish coloured fluid in the liver, occurring often as a single mass in the right lobe and a compilation of intestinal infection with Entamoeba histolytica. Lung, heart and brain infections are uncommon sequelae. Occasionally, pyogenic abscesses may have a similar clinical presentation.

Clinical Features 

SIGNS AND SYMPTOMS

  • Large tender liver.
  • Tenderness and/or bulging at right intercostal spaces.
  • Jaundice, dullness to percussion on the right lower chest zones with basal crepitation’s amoebic empyema following extension into the chest cavity.
  • Peritonitis (uncommon)

INVESTIGATIONS

  • Abdominal ultrasound
  • Chest X-ray
  • FBC
  • ESR
  • Stool examination
  • Abdominal CT scan
  • Serology (amoebic antibodies)

Treatment 

  • Give Metronidazole 800mg 8 hourly for 10 days
  • Give oral (preferably after food) or IV (depending on the condition of the patient)
  • If necessary, repeat treatment course after 2 weeks

REFERRAL CRITERIA

  • In cases of large abscesses or superficial abscesses, refer to the tertiary facility for aspiration under ultrasound guidance.