Amoebic Liver Abscess Associated with Viral Hepatitis C in an Elderly Patient

Abstract

Introduction: Amebic liver abscess is a suppurative collection of parasitic origin. The causative organism is usually the ubiquitous Entamoeba histolytica. In Mali, a study reported a hospital incidence rate of 2.4%. Radiological exploration of the liver has made a major contribution to improving early diagnosis and management. Treatment involves metronidazole and evacuation of the suppurative collection. We report the case of a 71-year-old patient who developed an amebic liver abscess associated to viral hepatitis C with a very high viral load. The diagnosis was made on the basis of clinical, biological and radiological signs, amoebic serology and the characteristic of the pus. Antiparasitic treatment, drainage of the abscess and antiviral treatment resulted in a good clinical outcome. The epidemiological, diagnostic and therapeutic characteristics of amebic abscesses are discussed. Conclusion: Hepatic amebiasis is common. Diagnosis is guided by the FONTAN triad, biology and imaging. The chocolate-coloured characteristic of the pus and the serology confirm the diagnosis. Treatment is medical and instrumental (ultrasound-guided). Association with hepatitis C infection appears to be rare.