Cases Of Amebic Liver Abscess Research Articles

Amebic liver abscess.

We report eight cases of amebic liver abscess. All patients were men, and four were homosexual. Five of the eight patients had syphilis, but the four homosexual patients who were tested for HIV infection were negative. Ultrasonography (US), with or without needle aspiration, is the best method for diagnosing amebic liver abscess, and the treatment of choice is US-guided needle aspiration of the abscess followed by metronidazole therapy. Complication by other sexually transmitted diseases is another important factor affecting the treatment of this disease.

Perforated Amebic Liver Abscess: Clinical Analysis of 110 Cases

In this study of 503 consecutive cases of amebic liver abscess documented during a 21-year period, 110 (22%) were complicated by perforation. Perforation sites included pleuropulmonary structures (79 cases, 72%) subphrenic space (15 cases, 14%); and peritoneal cavity (11 cases, 10%). The less common sites were the thoracic and abdominal wall, pericardial sac, bile duct, kidney, mediastinum, colon, and right flank. Trophozoites were recovered in 29% of cases. For the rest of the cases, diagnosis was based on the clinical manifestations and the dramatic response to a therapeutic trial of amebicides. Open surgical drainage was done in 10 of 11 patients who had peritoneal perforation; 6 of them were cured and 5 died. Of 97 patients with perforation sites other than the peritoneal cavity, 64 were treated with metronidazole in addition to needle aspiration and/or percutaneous catheter drainage, and all achieved complete remission without relapse during subsequent follow-up. Of the 36 cases treated with metronidazole alone, 22 (61%) were cured. The mortality rate in the group with perforated abscess was 17% (19/110), compared with 5% (25/503) in the whole series. The results suggested that (1) amebic liver abscess can be difficult to diagnose, especially when the pathogen is not isolated; and (2) metronidazole combined with needle aspiration and/or percutaneous catheter drainage is the treatment of choice for amebic liver abscess with perforation.

A case of amebic liver abscess with colonic carcinoma

A case of amebic liver abscess with colonic carcinoma

The prognostic factors of severe amebic liver abscess: a retrospective study of 125 cases.

One hundred twenty-five cases of amebic liver abscess were diagnosed at Chang Gung Memorial Hospital in Taiwan from January 1981 to December 1989. An analysis of possible prognostic factors for severe amebic liver abscess was done retrospectively. The majority of the patients came from the southern part of Taiwan. Severe amebic liver abscess was defined as the rupture of an abscess that was resistant to 72 hr of medical treatment, or complicated by secondary bacterial infection. The results showed significant differences between patients with severe liver abscess and those with more moderate forms of amebic liver abscess in indices such as jaundice, hemoglobin and serum bilirubin levels, and dyspnea, as well as in pulmonary changes (right diaphragm elevation, right pleural effusion) seen on chest radiographs. Those patients with diabetes mellitus also had greater evidence of severe liver abscess. Moderate cases that were treated with amebicides showed excellent responses (no mortality). Severe cases required, in addition to amebicide therapy, either percutaneous or surgical drainage of pus, especially in those patients with ruptured abscesses. Those patients with abscesses that ruptured into the thoracic cavity were treated by either thoracostomy or needle aspiration, and all were cured. Three patients died of abscess rupture into the abdominal cavity, associated with secondary bacterial infection. The overall mortality rate was 2.4%. These symptoms and signs of severe liver abscess are indicators of the need for intensive treatment such as aspiration or surgical drainage.

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

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

A comparative evaluation of percutaneous catheter drainage for resistant amebic liver abscesses

Resistance to drug treatment is a well-known problem in the management of patients with amebic liver abscesses. We undertook a comparison of the various modalities of treatment currently used for such cases on a prospective, randomized basis. Fifty patients with 56 amebic liver abscesses found to be resistant to drug therapy were included in the study. Repeat trial of conservative therapy, therapeutic needle aspirations, percutaneous catheter drainage, and open surgical drainage were the modalities of treatment employed. The responses to the various modalities were compared for clinical relief, morbidity, failure of response, period of hospital stay, and resolution of abscess cavity. The most impressive results were seen with percutaneous catheter drainage. This new modality of treatment is recommended for all resistant cases of amebic liver abscess.

アメーバ性肝膿ようの１例

アメーバ性肝膿ようの１例

ベトナム難民にみられたアメーバ性肝のうよう例

ベトナム難民にみられたアメーバ性肝のうよう例

A CASE OF HEPATIC AMEBIASIS PENETRATING TO THE LUNG

A case of amebic liver abscess with hepatobronchial fistula is reported in this paper. The patient was a 47-year-old man sufferinc from a spike fever and right hypochondralgia. Imacing diagnosis revealed a solitary liver abscess penetrating into the pleural space through the diaphragm. Thoracentesis for drainage, administration of antibiotics and surgical drainage of the liver abscess were performed, resulting in aggravation with complicated hepatobronchial fistula. Tentative occlusion of the hepatobronchial fistula with celform under endoscopy and administration of Metronidazole produced provisional improvement. Howerver, finally, patient died of multiple orcan failure. Recently, the diagnosis of this disease has become easy by serological tests, even in the early stage. Liver abscess aspiration is not advocated frequently as a therapentic measure. But when the abscess is big, especially with hepatobronchial fistula, sufficient drainage is necessary to prevent the spread of amebae.

Assessment of the sensitivity, specificity, and reproducibility of the indirect immunofluorescent technique for the diagnosis of amebiasis.

The indirect immunofluorescence (IIF) test was used to study antibody titers to Entamoeba histolytica in various manifestations of clinical amebiasis by comparing the results with parasitological and clinical data from confirmed cases. The sensitivity, specificity, and reproducibility of this test for diagnosis were also studied. A high degree of correlation was found between reactivity in the IIF test and confirmed cases of amebic liver abscess. A positivity rate of 96% in sera of confirmed cases of amebic liver abscess in the present study compares favorably with the results of other workers. The IIF test is very useful in the diagnosis of hepatic amebiasis but is less sensitive for amebic dysentery. The test could not be used to differentiate between hepatic amebiasis and amebic dysentery. The IIF test was insensitive for amebic colitis and of no diagnostic value. Specificity and reproducibility of the test were good, as shown by results obtained with sera from patients with parasitic infections other than amebiasis.

Cell-mediated immunity in patients with amebic abscess of the liver

Migration-inhibition factor (MIF) and delayed skin tests with axenic antigen obtained from Entamoeba histolytica were performed in 13 cases of amebic liver abscess and in 16 control individuals with no clinical or laboratory evidence of amebiasis. All subjects were of low socioeconomic condition, drawn from a community in Mexico City where amebiasis is highly endemic. Patients with amebic liver abscess revealed diminished cell-mediated immunity to E. histolytica antigen when tested by skin tests and for MIF production. Skin reactions to streptokinase-streptodornase were normal. When the same patients were tested 10 days after discharge from hospital, they all had normal delayed-type skin reactions and MIF production to E. histolytica antigen. During liver abscess as well as 10 days after successful treatment, sera from patients disclosed antibodies by counterelectrophoresis and passive hemagglutination tests. The importance of the relationship between performance of the tests and the clinical evolution of the disease is discussed.

The Mode of Action of Surface Lysosomes of Entamoeba histolytica in Human Infections

Biopsies were obtained from lesions in the rectal mucosa of 23 Orang Asli (aborigine) patients with amebic dysentary in order to study the morphology of Entamoeba histolytica trophozoites during active colonization of the intestinal mucosa. Liver tissue was also obtained in Costa Rica from a case of amebic liver abscess at autopsy. Biopsies were immediately fixed 3-8 hours in cold gluteraldehyde buffered with cacodylate. After fixation, specimens were washed, stored in buffer, and sent to New Orleans where the standard post-osmication, acid-phosphatase treatment, and Araldite embedding were accomplished. Tissue from Costa Rica was handled similarly. Sections were cut with diamond knives and examined at 50 KV in a Hitachii HU-11A.

The serum protein pattern, liver function tests and hematological findings in the differential diagnosis of amebic liver abscess.

Summary 1. The results of the haematological investigations, liver function tests and electrophoretic serum protein patterns are presented in 10 patients, each with cirrhosis of the liver, primary carcinoma of the liver and right basal pneumonia. 2. These findings are compared with each other, and with those in 31 cases of amebic liver abscess and 50 African controls. 3. It is concluded that, though the results indicate certain differences between these conditions, their value in differential diagnosis is not great.

Aureomycin in amebic liver abscess.

SummaryFive cases of amebic liver abscess in male Africans in which characteristic pus was obtained were treated with Aureomycin in a dose of 500 mgm. 6 hourly for 10 days.In two cases there was no response, in two cases possibly some response, and in one case an apparently good result was followed by recurrence in six weeks.The results have been compared with those obtained in similar cases with emetine and chloroquin diphosphate and it is concluded that Aureomycin is a much less effective drug.

Liver abscess part I: Amebic abscess analysis of 73 cases

1. 1. A study of 73 cases of amebic liver abscess is presented. 2. 2. The average age was forty-four years. The ratio of males to females was 8 to 1. 3. 3. Fifty-nine and six-tenths per cent gave a history of an antecedent diarrhea; 17.4 per cent showed amebae in the abscess and 36.1 per cent showed amebae in the stool in those cases in which these examinations were performed. 4. 4. The principal symptoms and signs were pain and tenderness, being found in 79.4 per cent. Fever and enlargement of the liver were found in 69.8 and 65.7 per cent, respectively. A diagnosis of amebic hepatitis was made preoperatively in 68.4 per cent. Positive x-ray diagnoses were made in 87.7 per cent. 5. 5. The prognosis in amebic hepatitis depends largely upon the presence of secondary infection and the type of operation used. In a series of 4035 cases collected from the literature, and including the authors' own cases, in which open operation was used, 1908 (47.2 per cent) ended fatally. In a similar series of 459 treated conservatively there were 32 deaths, a mortality rate of 6.9 per cent. 6. 6. In the authors' series of 70 cases in which treatment was used, 10 succumbed, 14.2 per cent mortality. Forty-six were operated upon with 9 deaths, a mortality rate of 19.5 per cent. Of these 16 were operated upon, employing the transpleural approach, with 4 deaths, a mortality rate of 25 per cent. Fourteen were operated upon through a right rectus incision with a 21.4 per cent mortality rate. Seven had simple incision and drainage over a presenting mass with a 14.2 per cent mortality rate. Nine had retroperitoneal operations with an 11.1 per cent mortality. 7. 7. The lowest mortality rate (4.1 per cent) was obtained in 24 cases treated conservatively by aspiration and the use of amebicides. 8. 8. The treatment of amebic hepatic abscesses which are not secondarily infected consists of aspiration and the use of amebicides and open operation should be employed only in those cases in which there is infection with pyogenic microorganisms.