A CASE OF AMEBIC ABSCES OF THE LIVER WITH DIFFICULTIES IN DIAGNOSING AND TREATING

Abstract

A 58-year-old man visited another hospital because of general fatigue and fever. He has never been abroad. CT revealed an area of hypoabsorption in the right lobe of the liver. Under a diagnosis of liver abscess antibiotic regimen was started, but no remission could be attained. The patient was referred to the department. On admission an increased leucocytes and impairment of the liver function were noted. CT revealed a huge hypoabsorbent area in the right lobe of the liver. Drainaging of the abscess and administration of antibiotics were started, however, no remission was obtained. As strong positive response to serum amebic antibody was observed, a diagnosis of amebic liver abscess was made. Antiamebic agents were administered. Unfortunately, severe jaundice and ARDS developed and the patient died of liver and respiratory failure on the 39th hospital day. These findings indicated that the patient had fluminating amebic liver abscess who might infected through some route in Japan. From this experience, we would emphasize the importance of early diagnosis and efficient prevention of complications. Some notes on relevant literature are also presented.