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[Clinical analysis of 36 cases with amebic liver abscess]
1Department of Infectious Diseases, Peking Union Medical College Hospital, Beijing 100730.
Objective:
To investigate the clinical features of amebic liver abscess, the causes of misdignosis and the effect of medical and surgical therapy on patient's prognosis.
Methods:
The clinical features of 36 patients with amebic liver abscess admitted from 1982 to 1997 in our hospital were retrospectively reviewed.
Results:
The major clinical manifestations were: abdominal pain (86.1%), fever (86.1%), hepatomegaly with tenderness (83.3%) and right intercostal tenderness (58.3%). Leukocytosis was observed in 61.1%, and increased of ESR in 88.5% (23/28). Serologies against Entamoeba histolytica were noted in 92.6%. Ultrasonography showed single lesions in 75% and right-lobe involvement in 75%. All patients were treated with metronidazole and 27 patients received treatment with needle aspiration or draining at the same time. After treatment, 10 patients were cured, 25 patients were improved significantly and effective rate was 97.2%. One patient died of hepatic failure.
Conclusion:
Medical therapy alone was excellent for small abscesses, while percutaneous needle aspiration or draining was a successful approach in patients with large abscesses.
Insights
This study on amebic liver abscess found that metronidazole is effective, with needle aspiration aiding large abscess treatment. Early diagnosis and appropriate therapy significantly improve patient prognosis, reducing mortality.
Area of Science:
- Hepatology
- Infectious Diseases
- Clinical Medicine
Context:
- Amebic liver abscess (ALA) is a significant helminthic infection, particularly in developing countries.
- Accurate diagnosis and timely intervention are crucial for favorable outcomes.
- Understanding clinical features and treatment efficacy is vital for patient management.
Purpose:
- To review the clinical presentation of amebic liver abscess.
- To identify factors contributing to misdiagnosis.
- To evaluate the effectiveness of medical and surgical interventions on patient prognosis.
Summary:
- Retrospective review of 36 patients with ALA revealed common symptoms: abdominal pain, fever, and hepatomegaly.
- Serological tests for Entamoeba histolytica were positive in 92.6% of cases.
- Metronidazole combined with needle aspiration for large abscesses achieved a 97.2% effective rate, with one mortality due to hepatic failure.
Impact:
- Highlights the efficacy of metronidazole for ALA.
- Demonstrates the benefit of percutaneous aspiration for larger abscesses.
- Emphasizes the importance of prompt diagnosis and tailored treatment strategies to improve patient survival and reduce complications.