Abstract
ObjectivesAmoebic liver abscess (ALA) is endemic to many areas of the world. This study sought to investigate the epidemiology, presentation, laboratory tests and imaging characteristics of ALA in Oman and ultimately determine whether it is native to Oman or originated abroad.MethodsThis case series study was conducted at the Royal Hospital, Muscat, Oman, from January 2013 to December 2017 with patients older than 13 years and having a discharge diagnosis of ALA. Patient data were extracted from the Royal Hospital patient database.Results22 patients were included in the study—18 Omani patients and four expatriates. Only two Omanis had a history of traveling abroad. There were 15 male patients and seven were female with an average age of 45.2 years. The most common presentation was abdominal pain, which was seen in 17 patients. Fever was seen in 13 patients. Alanine transferase was found to be elevated in 13 patients. The majority of patients (90%) had no symptomatic infections prior to developing ALA.ConclusionThe data suggests that ALA is endemic to Oman, considering the high number of local patients and lack of travel abroad in this population. As the number of patients treated for ALA is rather small, it can be concluded that the occurrence of ALA is much lower in Oman than in other endemic areas. The majority of patients had no prior symptomatic infections; thus, a method of control involves screening to prevent amoebic spread.
Highlights
Amebic liver abscess (ALA) results secondary to amebiasis caused by Entamoeba histolytica, a protozoan transmitted mainly through the fecal-oral route
This can occur by ingestion of water or food that is contaminated with cysts excreted via faeces.(1) Amebic infections are mostly asymptomatic, but invasive intestinal disease can occur starting in the colon when the invasive trophozoite form invades colonic mucosa and activates a strong immune response causing further tissue damage.(2) Access to mesenterial vessels can result in hematogenous amoebic dissemination to extra-intestinal sites potentially leading to a liver abscess.(3) ALAs are the most common extra-intestinal manifestation and have a widespread global impact, affecting developing countries with poor hygiene and inadequate sanitation.(4) Areas with high rates of ALA are the Indian subcontinent and East Asia, Africa, as well as Central and South America.(5) Immigration plays an important role in cases discovered in non-endemic areas
Like in other Gulf countries, Oman has a very large migrant-worker community from endemic areas in Asia and they constitute around 40% of the population.(8) It would, be natural to assume that the majority of ALA patients would be found in migrant patients
Summary
Amebic liver abscess (ALA) results secondary to amebiasis caused by Entamoeba histolytica, a protozoan transmitted mainly through the fecal-oral route. Like in other Gulf countries, Oman has a very large migrant-worker community from endemic areas in Asia and they constitute around 40% of the population.(8) It would, be natural to assume that the majority of ALA patients would be found in migrant patients. This was the reason to conduct this retrospective study that aimed to establish the epidemiological and clinical characteristics of ALAs in Oman and try to answer whether Oman is an area endemic to ALAs or are most of the cases imported
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
