Amoebic liver abscess

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  • 1.  
  • 2.
    • Entamoeba histolytica
    • Most common extraintestinal syndrome
    • Fever, RUQ pain, anorexia
    • Point tenderness RUQ area
    • Jaundice is rare
    • <30% will have a history of diarrhea
    • Must be included in the Ddx of FUO
  • 3.
    • Pleural effusion
    • Hepatobronchial fistula
    • Rupture into peritoneal cavity
    • Rupture into pericardium
  • 4.
    • Ultrasonography: solitary; R lobe
    • CT scan
    • MRI
    • Elisa
  • 5.  
  • 6.
    • 90% good response to metronidazole
    • Response in 72 hours
    • Indications:
    • To rule out pyogenic cause (multiple lesions)
    • Poor response after 72 hours
    • Imminent rupture
    • Prevent rupture into pericardium