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Current Status of Amebic Liver Abscess in Korea Comparing with Pyogenic Liver Abscess
Eunju Kim1, Dong-Hee Park1, Kyung-Joong Kim1
1Division of Gastroenterology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
Backgrounds/Aims:
With the improvement of hygiene, the incidence of amebic liver abscess is decreasing in South Korea. On the other hand, there is little data on the status of amebic liver abscess compared to pyogenic liver abscess.
Methods:
Patients with an amebic liver abscess, in whom Entamoeba histolytica (E. histolytica) IgG was positive, were identified retrospectively in a university hospital. The clinical, laboratory, and radiological characteristics of amebic liver abscess were compared with those of pyogenic liver abscess in the same period.
Results:
Between March 2010 and October 2016, 413 patients with a liver abscess were identified. Among them, the serologic test for E. histolytica was performed in 209 patients. Fifteen (7.2%) were classified as an amebic liver abscess, and the remainder were diagnosed with a pyogenic liver abscess. The age, gender, white blood cell, and CRP was comparable between the two groups. Procalcitonin was lower in amebic liver abscess than the pyogenic one. On CT, peripheral rim enhancement was more frequent, but cluster signs were not observed in amebic liver abscess compared to pyogenic liver abscess. None of the patients with amebic liver abscess died. In contrast, the mortality of pyogenic liver abscess was 4.7%.
Conclusions:
Amebic liver abscess should still be considered as one of the causes of liver abscess in Korea. It is difficult to discriminate an amebic liver abscess from a pyogenic liver abscess only according to the clinical, laboratory, and radiologic findings. Therefore, it is necessary to perform a serologic test for E. histolytica for a precise evaluation of liver abscess in a high-risk group.
Insights
Amebic liver abscess remains a concern in Korea, though less common than pyogenic liver abscess. Early serologic testing for Entamoeba histolytica is crucial for accurate diagnosis.
Area of Science:
- Infectious Diseases
- Hepatology
- Medical Diagnostics
Background:
- Improved hygiene has decreased amebic liver abscess (ALA) incidence in South Korea.
- Limited data exists comparing ALA to pyogenic liver abscess (PLA) in the region.
Purpose of the Study:
- To compare the clinical, laboratory, and radiological characteristics of ALA with PLA.
- To assess the diagnostic utility of serologic testing for Entamoeba histolytica.
Main Methods:
- Retrospective analysis of liver abscess patients (n=413) from 2010-2016.
- Serologic testing for Entamoeba histolytica (E. histolytica) performed on 209 patients.
- Comparison of clinical, laboratory (WBC, CRP, procalcitonin), and CT findings between ALA (n=15) and PLA groups.
Main Results:
- ALA (7.2%) was less frequent than PLA. Procalcitonin was lower in ALA. Peripheral rim enhancement on CT was more common in ALA; cluster signs were absent.
- No mortality was observed in the ALA group, while PLA had a 4.7% mortality rate.
- Clinical, laboratory, and radiological findings showed limited discriminatory power between ALA and PLA.
Conclusions:
- Amebic liver abscess should be considered in the differential diagnosis of liver abscesses in Korea.
- Serologic testing for E. histolytica is essential for accurate diagnosis, especially in high-risk individuals.
- Distinguishing ALA from PLA based solely on clinical, laboratory, or imaging data is challenging.
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