Presentation
Here, the author reports the clinical presentations of the amebic liver abscess in 62 Thai patients. The author also presents some notification on the clinical presentations among the HIV seropositive and HIV seronegative patients in our series. [bmcfampract.biomedcentral.com]
Patients presenting at University of California, Los Angeles Hospital with acute abdominal injuries who underwent exploratory laparotomy and subsequently were found to have an amebic hepatic abscess were studied. [ncbi.nlm.nih.gov]
Hypoferremia and a low TIBC were also present in those patients who were not anemic. Iron deficiency and evidence of hemolysis were not present and the findings are consistent with those described in the anemia of infection. [ajtmh.org]
His past medical history was significant for a femoro-popliteal bypass, which he underwent several years before presentation. [academic.oup.com]
Entire Body System
- Pain
But people with amebic liver abscess do have symptoms, including: Abdominal pain, more so in the right, upper part of the abdomen; pain is intense, continuous or stabbing Cough Fever and chills Diarrhea (in only one-third of patients) General discomfort [account.allinahealth.org]
The accumulating pus and the adjacent swollen, inflamed tissues press against the nerves, causing pain. The concentration of blood in the area causes redness. [medical-dictionary.thefreedictionary.com]
Their toxicity includes cardiac arrhythmias, precordial pain, muscle weakness, vomiting, and diarrhea. Dehydroemetine is less toxic than emetine. [emedicine.medscape.com]
- Fever
This case report represents such a failure.Case ReportA 19-year-old man was admitted to the hospital because of fever and vomiting. Chills and fever had begun 4 days earlier, followed by epigastric discomfort and vomiting. [nejm.org]
Features of MyAccess include: Remote Access Favorites Save figures into PowerPoint Download tables as PDFs Go to My Dashboard Close Fever, abdominal pain Amebas or antigen in stool or abscess aspirate Positive serologic tests but may represent prior infections [accessmedicine.mhmedical.com]
The common clinical presentations include fever, abdominal pain, and abdominal tenderness. There are clinical differences between amebic liver abscess and pyogenic liver abscess. [academic.oup.com]
Case Report A 38 years old male presented with fever, pain in right upper abdomen for 12 days and pain and swelling of both ankles and right knee for4 days. The fever was high grade and continuous and associated with chills and nausea. [jpma.org.pk]
These include fever, abdominal pain, fatigue, and nausea with fever being the most common symptom present in up to 90% of cases of pyogenic abscesses. [clinicaladvisor.com]
- Weight Loss
loss Intercostal tenderness Diarrhea is present in a small number of patients Abscesses are most commonly single and in the right lobe of the liver Amebic infections may rarely occur throughout the body, including the lungs, brain, and genitourinary [accessmedicine.mhmedical.com]
[…] of appetite Sweating Weight loss Treatment Antibiotics such as metronidazole (Flagyl) or tinidazole (Tindamax) are the usual treatment for liver abscess. [account.allinahealth.org]
[…] of appetite Sweating Weight loss Antibiotics such as metronidazole (Flagyl) or tinidazole (Tindamax) are the usual treatment for liver abscess. [medlineplus.gov]
[…] of appetite Sweating Weight loss Exams and Tests The health care provider will perform a physical examination. [ufhealth.org]
- Chills
Chills and fever had begun 4 days earlier, followed by epigastric discomfort and vomiting. All symptoms persisted until the time of admission. [nejm.org]
Most of the patients were suffering from abdominal pain (85.5 %), fever and chills (74.2 %), and abdominal tenderness (69.4 %; Table 2 ). [bmcfampract.biomedcentral.com]
But people with amebic liver abscess do have symptoms, including: Abdominal pain, more so in the right, upper part of the abdomen; pain is intense, continuous or stabbing Cough Fever and chills Diarrhea (in only one-third of patients) General discomfort [account.allinahealth.org]
- Rigor
URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. [leehealth.org]
The fever was high grade, intermittent and associated with chills and rigors. Abdominal pain was dull in nature and generalized and began from the periumbilical region with no known relieving or aggravating factors. [ispub.com]
Fever is typically remitting with a prominent evening rise with brief rigors and profuse sweating. Often there is anaemia and a dry painful cough. [patient.info]
] Magnetic resonance cholangiopancreatography (MRC) image showing a voluminous and heterogeneous collection in the left liver lobe (amoebic abscess) Symptoms Pain right hypochondrium referred to right shoulder Pyrexia (100.4 F) Profuse sweating and rigors [en.wikipedia.org]
Respiratoric
- Cough
However, the patient still experienced cough, with white sputum and no hemoptysis. [idpjournal.biomedcentral.com]
But people with amebic liver abscess do have symptoms, including: Abdominal pain, more so in the right, upper part of the abdomen; pain is intense, continuous or stabbing Cough Fever and chills Diarrhea (in only one-third of patients) General discomfort [account.allinahealth.org]
- Pneumonia
[…] single and in the right lobe of the liver Amebic infections may rarely occur throughout the body, including the lungs, brain, and genitourinary system Pyogenic liver abscess Echinococcosis (hydatid disease) Cholecystitis or cholangitis Right lower lobe pneumonia [accessmedicine.mhmedical.com]
By contrast, Klebsiella pneumoniae primary liver abscesses are monomicrobial and occur without associated hepatobiliary disease. [clinicaladvisor.com]
[…] intraabdominal infection (peritonitis, diverticulitis, etc), 3) Hematogenous seeding - Microbiology: Polymicrobial - mostly enteric gram negatives and anaerobes, Staph and Strep (including Strep anginosus group - propensity for abscesses), Klebsiella pneumoniae [errolozdalga.com]
The patient who stayed for 37 days developed nosocomial pneumonia that resolved after antibiotic treatment. In three cases, nosocomial pneumonia was diagnosed and these patients received treatment for both conditions. [omicsonline.org]
Diagnosis Code A06.4 Amebic liver abscess 2016 2017 2018 2019 Billable/Specific Code Applicable To Hepatic amebiasis with brain abscess A06.6 (and liver or lung abscess) lung (miliary) (putrid) J85.2 ICD-10-CM Diagnosis Code J85.2 Abscess of lung without pneumonia [icd10data.com]
- Pleural Effusion
Chest roentgenograms showed small to massive pleural effusions, basal pneumonitis, and cardiomegaly; serology, liver scans, and induced pneumoperitoneum were diagnostic. [ncbi.nlm.nih.gov]
An amebic empyema was differentiable from sympathetic pleural effusions by its hyperintensity on both T1- and T2-weighted images. [pubs.rsna.org]
A chest X-ray revealed a pleural effusion in the right hemithorax. Computed tomography (CT) scanning of the chest and abdomen revealed a pleural effusion and a liver abscess (Figure 1 ). [jmedicalcasereports.biomedcentral.com]
effusion perihepatic fluid collection gastric or colonic involvement retroperitoneal extension Ultrasound May appear as a hypoechoic lesion with low-level internal echoes and absence of significant wall echoes. [radiopaedia.org]
Gastrointestinal
- Abdominal Pain
Features of MyAccess include: Remote Access Favorites Save figures into PowerPoint Download tables as PDFs Go to My Dashboard Close Fever, abdominal pain Amebas or antigen in stool or abscess aspirate Positive serologic tests but may represent prior infections [accessmedicine.mhmedical.com]
Thomason Hospital in El Paso with a 5-day history of abdominal pain, fever, and diarrhea. His abdominal pain was diffuse and accompanied by mild rectal bleeding that he attributed to hemorrhoids. [academic.oup.com]
In rare cases, the abscess may need to be drained using a catheter or surgery to relieve some of the abdominal pain. [account.allinahealth.org]
But people with amebic liver abscess do have symptoms, including: Abdominal pain, more so in the right, upper part of the abdomen; pain is intense, continuous or stabbing Cough Fever and chills Diarrhea (in only one-third of patients) General discomfort [medlineplus.gov]
- Loss of Appetite
[…] of appetite Sweating Weight loss Treatment Antibiotics such as metronidazole (Flagyl) or tinidazole (Tindamax) are the usual treatment for liver abscess. [account.allinahealth.org]
[…] of appetite Sweating Weight loss Antibiotics such as metronidazole (Flagyl) or tinidazole (Tindamax) are the usual treatment for liver abscess. [medlineplus.gov]
[…] of appetite Sweating Weight loss Exams and Tests The health care provider will perform a physical examination. [ufhealth.org]
- Right Upper Quadrant Pain
Clinical symptoms are classically persistent fever and right-upper-quadrant pain. The presence of diarrhea (reflecting concurrent intestinal amebiasis) is more variable. Presentation usually occurs with 4 months after return from endemic areas. [patient-help.com]
Patients may experience general malaise or present with frank sepsis and right upper quadrant pain. [radiopaedia.org]
In patients with right upper quadrant pain, radiation to right shoulder was present in 14% (n=7). Other symptoms are reported in Figure 1. [omicsonline.org]
Diffuse abdominal pain, pleuritic chest pain, and radiation of right upper quadrant pain to the right shoulder are not uncommon. Epigastric pain is commonly seen in left lobe abscesses. [ispub.com]
- Acute Diarrhea
Acute diarrhea in adults: clinical appearance and therapeutic aspects. Scand. 3. Infect Dis., 1988;20:303-14. 8. Fraser, J. R. A. Epidemic polyparthritis and Ross River Virus disease. Clin. Rheum. Dis., 1986;12:2-5. 9. Kandolf, R., Kirchner, P.. [jpma.org.pk]
Liver, Gall & Pancreas
- Jaundice
In our study, the frequency of multiple liver abscesses was more in cases with jaundice (52.2%) as compared to those without jaundice (30.8%). [omicsonline.org]
Jaundice is a rare manifestation of hepatic amebic abscess. [atmph.org]
Liver cancer Inherited diseases, such as hemochromatosis and Wilson disease Symptoms of liver disease can vary, but they often include swelling of the abdomen and legs, bruising easily, changes in the color of your stool and urine, and jaundice, or yellowing [icdlist.com]
[…] pain, more so in the right, upper part of the abdomen; pain is intense, continuous or stabbing Cough Fever and chills Diarrhea (in only one-third of patients) General discomfort, uneasiness, or ill feeling ( malaise ) Hiccups that do not stop (rare) Jaundice [account.allinahealth.org]
- Hepatomegaly
Invasion of the liver undoubtedly occurs in every patient with amebiasis, and many patients with amebiasis have a large, tender liver (hepatomegaly) (43 to 50 per cent). 1 However, the incidence of liver abscess FULL TEXT [annals.org]
On examination, patients have hepatomegaly and point tenderness over the liver. Rupture of the abscess may cause peritonitis. Diagnosis. Serologic tests for amebic infestation are positive in nearly 100% of affected patients. [patient-help.com]
ALP isoenzyme test (Medical Encyclopedia) Ascites (Medical Encyclopedia) Diet - liver disease (Medical Encyclopedia) Hepatic encephalopathy (Medical Encyclopedia) Hepatomegaly (Medical Encyclopedia) Liver disease (Medical Encyclopedia) Liver scan (Medical [icdlist.com]
MyAccess include: Remote Access Favorites Save figures into PowerPoint Download tables as PDFs Go to My Dashboard Close Fever, abdominal pain Amebas or antigen in stool or abscess aspirate Positive serologic tests but may represent prior infections Hepatomegaly [accessmedicine.mhmedical.com]
Abdominal ultrasonography revealed multiple hepatic cysts, largest measuring 18 × 17 × 10 cm with hepatomegaly (21 cm) and simple left renal cyst (3 × 3 cm). [mjdrdypu.org]
Neurologic
- Agitation
On examination, he was conscious but disoriented, dysphasic agitated, pale, and incontinent. Decreased breath sounds in the right lower zone, neck rigidity, and Kernig's sign were present. [neurologyindia.com]
Workup
[…] examination of the lung revealed trophozoites of Entamoeba histolytica. a, b Haematoxylin Eosin (HE) stain; c, d Periodic acid–Schiff (PAS) stain; arrows refer to the amoebic trophozoites) Fig. 4 The timeline of the patient’s medical history, diagnostic workup [idpjournal.biomedcentral.com]
Serum
- Neutrophilia
Liver function tests are usually unremarkable, but neutrophilia is often present with normal eosinophils. 4 Current evidence suggests no additional benefit of aspiration over medical treatment alone. 5 Complications include abscess rupture, bacterial [academic.oup.com]
Investigations revealed mild elevation of total bilirubin (2 mg%) with elevated alkaline phosphatase (238 IU/L) and neutrophilia. His chest X-ray (CXR) showed cardiomegaly, and electrocardiogram (ECG) showed tachycardia with low voltage complexes. [atmph.org]
Ultrasound
- Enlargement of the Liver
Young children Pregnant women Persons who are malnourished Persons receiving corticosteroids Hepatic abscesses more common in men Many patients do not have current or a past history of intestinal symptoms Acute or gradual onset of abdominal pain Fever Enlarged [accessmedicine.mhmedical.com]
If diaphragmatic surface of the liver is involved, right pleural pain or shoulder pain can be observed. Enlargement of the liver with point tenderness is a typical finding. [news-medical.net]
Microbiology
- Entamoeba Histolytica
Differential detection of Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii by a single-round PCR assay. J Clin Microbiol. 2006 Sep. 44(9):3196-200. [Medline]. Khairnar K, Parija SC. [emedicine.medscape.com]
PubMed Search : Entamoeba histolytica [TI] liver abscess[TI] Advertisement Page views in 2018: 3,173 Page views in 2019 to date: 2,056 Cite this page: Arora K. Entamoeba histolytica abscess. [pathologyoutlines.com]
Haque R, Neville L M, Hahn P, Petri W A., Jr Rapid diagnosis of Entamoeba infection by using Entamoeba and Entamoeba histolytica stool antigen detection kits. [ncbi.nlm.nih.gov]
Pleura
- Pleural Effusion
Chest roentgenograms showed small to massive pleural effusions, basal pneumonitis, and cardiomegaly; serology, liver scans, and induced pneumoperitoneum were diagnostic. [ncbi.nlm.nih.gov]
An amebic empyema was differentiable from sympathetic pleural effusions by its hyperintensity on both T1- and T2-weighted images. [pubs.rsna.org]
A chest X-ray revealed a pleural effusion in the right hemithorax. Computed tomography (CT) scanning of the chest and abdomen revealed a pleural effusion and a liver abscess (Figure 1 ). [jmedicalcasereports.biomedcentral.com]
effusion perihepatic fluid collection gastric or colonic involvement retroperitoneal extension Ultrasound May appear as a hypoechoic lesion with low-level internal echoes and absence of significant wall echoes. [radiopaedia.org]
Treatment
The remaining three lesions showed slightly increased or decreased hepatic echogenicity after treatment. [ncbi.nlm.nih.gov]
Antibiotics such as metronidazole (Flagyl) or tinidazole (Tindamax) are the usual treatment for liver abscess. [pennstatehershey.adam.com]
Prognosis
For simple abscess, the prognosis is excellent. [ncbi.nlm.nih.gov]
Prognosis/Outlook for Amoebic Abscess or Amoebic Liver Abscess In most cases, patients the prognosis/outlook for amoebic abscess or amoebic liver abscess is good as patients successfully respond to treatment. [epainassist.com]
Etiology
The etiology diagnosis and treatment of amebiasis. Baltimore : Williams & Wilkins Co. 1944 viii 332 pp. Craig C. F. The etiology diagnosis and treatment of amebiasis. Baltimore: Williams & Wilkins Co. 1944 viii 332 pp. [thejns.org]
(Etiology) Amebic Liver Abscesses are caused by the parasite Entamoeba histolytica. When the parasite enters the body, it usually travels to the intestines. [dovemed.com]
Etiology and pathology of amebic liver abscess, Lancet, 1:463, 1922. CrossRef Google Scholar 5. Rogers, Sir Leonard and Megaw, J. W. D.: Tropical Medicine, Philadelphia, P. Blakiston’s Son and Co., 1930. Google Scholar 5a. [springerlink.com]
PubMed Google Scholar Branum GD, Tyson GS, Branum MA, Meyers WC: Liver abscess: changes in etiology, diagnosis, and management. Ann Surg. 1990, 212: 655-62. [bmcfampract.biomedcentral.com]
Epidemiology
Epidemiologically, amebiasis occurs in clusters in the United States with person-to-person transmission pre-dominant in spread. Infection is associated with poor sanitation and crowding. [pediatrics.aappublications.org]
In this article the most recent available information is reviewed relating to epidemiology, pathogenesis, presentation, diagnosis, and treatment. [ncbi.nlm.nih.gov]
A comprehensive, and profusely illustrated description of the common and uncommon images which will be found in a wide range of tropical diseases, correlated with the clinical and laboratory findings, and the epidemiology and pathology. [books.google.com]
Pathophysiology
This article reviews epidemiologic features, pathophysiology, clinical features, diagnostic tests, imaging studies, treatment of amebic liver abscess, and prevention measures. [ncbi.nlm.nih.gov]
Published on Dec 28, 2015 Pathophysiology, clinical features and management of amoebic liver abcess 1. AMOEBIC LIVER ABSCESS Kaushik.P 2. Amoebic abscess is a complication of amoebic dysentry which is caused by entamoeba histolytica. [slideshare.net]
References: [1] [3] Pathophysiology Clinical features Incubation period Intestinal amebiasis : 1–4 weeks Extraintestinal amebiasis : a few weeks to several years Clinical courses Intestinal amebiasis (dysentery) Loose stools with mucus and bright red [amboss.com]
Highly detailed discussion of the pathophysiology and immune evasion of amebiasis. PubMed Google Scholar 27. Aucott JN, Ravdin JI: Amebiasis and ’nonpathogenic’ intestinal protozoa. Infect Dis Clin North Am 1993, 7 :467–485. [link.springer.com]
Prevention
This is very important to prevent amoebic abscess or amoebic liver abscess. After visiting the toilet, ensure that you wash your hands thoroughly with soap and water and wipe your hands dry to prevent amoebic abscess or amoebic liver abscess. [epainassist.com]
Prevention When traveling in tropical countries with poor sanitation, drink purified water and do not eat uncooked vegetables or unpeeled fruit. Symptoms There are usually no symptoms of intestinal infection. [account.allinahealth.org]
This article reviews epidemiologic features, pathophysiology, clinical features, diagnostic tests, imaging studies, treatment of amebic liver abscess, and prevention measures. [ncbi.nlm.nih.gov]
A drug such as paromomycin or diloxanide must also be taken to get rid of all the ameba in the intestine and to prevent the disease from coming back. This treatment can usually wait until after the abscess has been treated. [pennstatehershey.adam.com]