A CASE OF AMEBIC LIVER ABSCESS IN A HOMOSEXUAL MAN WITH NO EFFECT OF PERCUTANEOUS DRAINAGE

Abstract

We experienced a case of amebic liver abscess in a 39-year-old homosexual man. The patient was admitted to the hospital because of tenderness on the right hypochondrium and fever. Ultrasound and CT revealed a liver cyst 8cm in diameter in S 7. An ultrasound-guided percutaneous liver drainage was unsuccessful and the abscess ruptured into the peritoneal cavity two days after the percutaneous liver drainage. Open peritoneal drainage was performed. Their administration of metronidazole was started with good outcome; the patient was upgraded to good condition. A retrograde bacterial infection developed through the drainage tube. Antibiotics were administrated, which controlled the infection, and the tube was subsequently removed. The patient was discharged and left the hospital on foot. There was a rapid increase in the number of reported cases of amebiasis in Japan after 1980. Most of these patients were thought to be homosexual men, and this disease is thought to be a prevalent sexually transmitted amebiasis. The serologic test is the most reliable option for diagnosis. An amebic abscess must be suspected if an abscess is found in the patient's liver. Metronidazole must be administrated to the patient as soon as possible, and the drainage procedure should be avoided except some special cases.