[Amebic liver abscess--diagnostic and therapeutic advances]

Liver abscess is the most frequent complication of intestinal disease caused by entamoeba histolytica. Noninvasive procedures are nowaday most important in establishing the diagnosis: sonography, scintigraphy and computer tomography (CT). Sonography is rather precise and should be used in the first place. Recently it became possible to demonstrate specific antigens to amoeba in the pus of the abscess or in liver biopsy material; this procedure has been proven to be dependable and fast in establishing a diagnosis. Serological methods like indirect hemagglutination tests usually show positive results in high titers. The clinical picture, serological and immunological diagnostic procedures as well as demonstration of intrahepatic defects by sonography and/or scintigraphy usually help to establish a diagnosis fastly; only in a few cases will it be necessary to do computer tomography additionally. Metronidazole, tinidazole and other nitroimidazoles have led to a considerable decrease of lethality, which used to be rather high before. Treatment of the intestinal disease caused by amoebae should not be forgotten. Cortisone is contraindicated.