Overview
Causes
- Immigrants from endemic areas
- Institutionalized persons, especially people with mental retardation
- Crowding and poor hygiene
- Men who have sex with men (secondary to sexually acquired amebic colitis)
- Presence of immunosuppression (eg, HIV infection, malnutrition with hypoalbuminemia, alcohol abuse, chronic infections, posttraumatic splenectomy, steroid use)
Symptoms
- Fever
- Abdominal pain, particularly in the right, upper region. Pain may be intense, continuous, or stabbing.
- General discomfort, uneasiness, or ill feeling (malaise )
- Sweating
- Chills
- Loss of appetite
- Weight loss
- Diarrhea
- Jaundice
- Joint pain
Risk factors
- Malnutrition
- Old age
- Pregnancy
- Steroid use
- Cancer
- Immunosuppression
- Alcoholism
- Recent travel to a tropical region
- Homosexuality, particularly in males
Exams and Tests
Tests that may be done include : -
- Abdominal ultrasound
- Abdominal CT scan or MRI
- Complete blood count
- Liver biopsy - rarely done due to high risk of complications
- Liver scan
- Liver function tests
- Serology for amebiasis
Diagnosis
- Examination
- Ill-appearance
- Fever
- Tender right upper abdomen
- Palpable liver (liver can be felt) whereas the liver is not easily felt
- Tenderness in chest wall of right chest
- Laboratory tests
- Anemia
- Elevated white blood cell count
- Hemagglutination test
Imaging : -
- Chest X-Ray shows elevated right diaphragm
- Ultrasound
- CT scan 20 days after successful treatment to eradicate ameba cysts
- MRI
Treatment
A medicine called metronidazole (Flagyl) is the usual treatment for liver abscess. Medications such as paromomycin must also be taken to remove intestinal amebiasis to prevent recurrence of the disease. In rare cases, the abscess may need to be drained to help relieve some of the abdominal pain.
Complications
The abscess may rupture into the abdominal cavity, the lining of the lungs, the lungs, or the sac around the heart. The infection can also spread to the brain.
For more information, medical assessment and medical quote
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