Nonresolution of an amebic liver abscess after parasitologic cure

A 43-year-old Filipino male was admitted to a Manila hospital with a 1 month history of epigastric pain and fever, and was found to have a palpable epigastric mass. Computerized tomography revealed a large hepatic abscess which serologically was shown to be amebic. Chemotherapy resulted in clinical cure and an initial reduction in size of the liver abscess. However, resolution of the abscess cavity did not occur, and on closed needle aspiration, 80 cc of characteristic amebic pus was recovered. Parasitological cure without complete repair of the abscess cavity itself raises questions concerning the potential danger of clinically silent residua and the role of therapeutic aspiration in the management of amebic liver abscesses.