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Common presentations of amebic liver abscess
R J Hoffner1, T Kilaghbian, V I Esekogwu
1Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA.
Annals of Emergency Medicine
|August 25, 1999
Summary
Amebic liver abscess, a severe Entamoeba histolytica infection, often presents with fever and right upper quadrant pain. Early diagnosis using ultrasonography in the emergency department is crucial for timely treatment with metronidazole.
Area of Science:
- Infectious Diseases
- Hepatology
- Gastroenterology
Background:
- Amebic liver abscess is the most common extraintestinal manifestation of Entamoeba histolytica, the causative agent of amebiasis.
- This global infection can lead to severe, life-threatening complications.
- The nonspecific nature of symptoms often complicates early diagnosis.
Purpose of the Study:
- To identify common presentation patterns of amebic liver abscess.
- To aid in the recognition of this condition in emergency departments.
- To improve diagnostic accuracy and patient outcomes.
Main Methods:
- Retrospective case series of patients with confirmed amebic liver abscess over a 5-year period.
- Review of emergency department and inpatient records, including demographics, symptoms, physical and laboratory findings.
- Analysis of diagnostic modalities such as ultrasonography, CT scan, chest radiograph, and serum antibodies.
Main Results:
- 75 patients reviewed; 80% male, mean age 35.5, 64% from Mexico.
- Common symptoms: fever (77%), right upper quadrant abdominal pain (72%).
- Ultrasonography (85%) and serum antibody titers (88%) were key diagnostic tools; ED diagnosis accuracy was 31.5%.
Conclusions:
- Amebic liver abscesses are diagnosed in US EDs, particularly in areas with immigrant populations from endemic regions.
- Fever and RUQ pain in Hispanic men warrant high suspicion.
- Bedside ultrasonography is valuable for diagnosis, with metronidazole as primary treatment.