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[Hepatic amebiasis: study of 152 cases]
Abstract:
The purpose of this study was to describe and analyse retrospectively the clinical, serological, anatomical and evolutive features of 152 cases of hepatic amebiasis in young adults, treated and followed up in France from 1969 to 1983. The disease was revealed 3 times out of 4 by tender hepatomegaly with fever, but only in 6 cases by complications. Serological tests (immunofluorescence or hemagglutination) were always positive for amebiasis, whereas Entamoeba histolytica was absent from stools in 96.7 p. 100 of the cases. Hepatic amebiasis always caused a hepatic abscess: in these cases, the superiority of ultrasonography over all other diagnostic methods was confirmed, especially concerning the detection of multiple abscesses (47 p. 100). Complete recovery was obtained by medical treatment in 117 cases, either alone (98 cases), or combined with needle aspiration (19 cases). Nitro-imidazoles are the simplest treatment, but nevertheless in 5 cases they were not effective. These patients were then treated with dehydroemetine, associated in 2 cases with surgery. Four patients relapsed at mid or long-term after apparent recovery, in the absence of any obvious reinfection. A significant correlation between the course of the treated disease and the size and number of abscesses was demonstrated: it was possible to define a group characterized by a slow and/or complicated course (with single abscess of the right lobe whose diameter is equal to or greater than 10 cm, or multiple abscesses). The pathogenesis of hepatic amebiasis is not yet fully understood.
Insights
This retrospective study analyzed 152 young adults with hepatic amebiasis, finding ultrasonography superior for diagnosing liver abscesses. Most patients recovered with medical treatment, though abscess size and number impacted outcomes.
Area of Science:
- Hepatology
- Infectious Diseases
- Parasitology
Context:
- Hepatic amebiasis is a significant parasitic infection affecting the liver.
- Understanding its clinical, serological, and anatomical features is crucial for effective management.
- This study provides insights from a cohort treated in France between 1969 and 1983.
Purpose:
- To retrospectively describe and analyze the clinical, serological, anatomical, and evolutive features of hepatic amebiasis in young adults.
- To evaluate diagnostic methods, particularly ultrasonography, for hepatic abscesses.
- To assess treatment outcomes and identify factors influencing disease course.
Summary:
- The study reviewed 152 cases of hepatic amebiasis in young adults.
- Hepatomegaly and fever were common presenting symptoms; serological tests were consistently positive, while Entamoeba histolytica was rarely found in stool.
- Ultrasonography proved superior for detecting liver abscesses, especially multiple ones. Complete recovery was achieved in most cases with medical therapy, sometimes combined with needle aspiration. Nitro-imidazoles were the primary treatment, with dehydroemetine used for refractory cases.
- Relapses occurred in some patients, and a correlation was found between disease severity and abscess characteristics (size, number, location).
Impact:
- Ultrasonography is confirmed as a key diagnostic tool for hepatic amebiasis.
- Treatment strategies involving medical therapy and, in some cases, needle aspiration or surgery, lead to recovery.
- Identifying prognostic factors like abscess size and number aids in predicting disease course and managing patients.
- Further research into the pathogenesis of hepatic amebiasis is warranted.