Diagnosis and treatment of hepatic amebic abscess in children

Abstract

From 1 January 1976 to 31 December 1985, 11 children under the age of 12 years (range 11 months to 11 years) were treated for hepatic amebic abscess at the UCLA-affiliated hospitals with no mortality. There were 7 girls and 4 boys, and all were of Mexican or Mexican-American descent. In only 3 instances (27%) was the correct diagnosis considered on admission. In 3 patients the diagnosis was made when symptoms persisted following a negative laparotomy for appendicitis, but all 3 made a complete recovery on medical therapy. A delay in diagnosis in 2 other patients contributed to intrahospital rupture of the abscess and resultant urgent surgical drainage. In the remaining 6 patients, amebicidal therapy alone proved effective and no surgery was required. The complex of fever, abdominal pain, anemia, leukocytosis, and elevated erythrocyte sedimentation rate in a child without a definite diagnosis should prompt the clinician to entertain an early diagnosis of amebic liver abscess and to begin immediate therapy with a safe and efficacious drug.