Amoebic liver abscess: clinical presentation and diagnosis

The clinical profiles of 16 patients with amoebic liver abscesses referred to Royal Perth Hospital over a ten-year period were assessed. The results indicate that amoebic abscess should be suspected in Asian migrants and farmers, or patients who have travelled in endemic areas, who present with fever, anorexia, weight loss and abdominal pain. Localized right hypochondriac tenderness, hepatomegaly and chest signs may be exhibited. The presence of anaemia, leucocytosis and marked elevation of the ESR, with moderate elevation of the serum alkaline phosphatase level, should heighten the probability of the diagnosis, which is readily confirmed by radionuclide liver scan or ultrasound, and elevation of the Entamoeba histolytica fluorescent antibody titre. The availability of metronidazole as a potent amoebicidal drug has reduced the need for surgical intervention in this condition.