A CASE OF AMEBIC LIVER ABSCESS IN A PATIENT ON CHRONIC HEMODIALYSIS

Abstract

We report a case of amebic liver abscess in a patient on chronic hemodialysis as well as its drug regimen. A 42-year-old single man who was undergoing long-term dialysis complained of fever and right hypochondralgia and was admitted to our hospital. A space-occupying lesion (10cm in diameter) was found on abdominal CT in the right lobe of the liver. He was diagnosed as having hepatic amebiasis because of a positive serologic test. Patients with amebic liver abscess were formerly more likely to have had recent travels to endemic areas, but recently this disease had become predominant among patients with depressed immune response. The immunological mechanism of resistance to infection is disturbed in patients on regular dialysis treatment and this disturbance interferes with the host-parasite equilibrium. Recently metronidazole or tinidazole is employed in the initial treatment of this disease. The metabolites of metronidazole, however, are slowly excreated and possibly accumulated in the patients with chronic renal failure, for which hemodialysis can efficiently remove. We successfully treated this patient with metronidazole 500mg daily, which corresponded to about one third of the usual dosage, without any toxic side