Amoebic vs pyogenic liver abscesses: A comparative study in a tertiary care hospital

Abstract

Background and Objectives: Liver abscess is a potentially life-threatening condition with a majority of cases being amoebic in tropical countries. In India, poor sanitary conditions and low socioeconomic status contribute to the endemicity of amoebiasis. As treatment modalities are different for amoebic and pyogenic liver abscesses (ALA and PLA, respectively), it is necessary to differentiate them. Facilities for amoebic culture are not available and microscopy is nondiscriminatory, hence serological tests are greatly relied upon for the identification. No studies have been done so far in our region on patients admitted with liver abscess. The aims of this study were to find the aetiology of liver abscess in admitted patients and to know the proportion of amoebic liver abscess using serological techniques. Materials and Methods: The study was done for 6 months and the sample size was 50. The ultrasonography (USG)-guided aspirates were subjected to microscopy and aerobic and anaerobic cultures on appropriate media. Serum samples of all patients were examined for Entamoeba histolytica immunoglobulin G (IgG) antibodies by enzyme-linked immunosorbent assay (ELISA) along with 35 control samples. Results: Of the 50 patients, 34 were diagnosed as amoebic by (ELISA) (68%), 11 as pyogenic (22%) and five as indeterminate (10%). Alcohol was found to have a higher association with ALA than with PLA. Of the 34 amoebic liver abscesses, only four (8.8%) showed motile trophozoites. The mortality rate was only 2.2%. Conclusion: Rapid diagnosis with serology and prompt treatment can result in reduced hospital stay in cases of ALA.