[Amebic liver abscess: sonographic and clinical observations on 20 patients]

A retrospective analysis of 20 patients with amoebic liver abscesses was performed. Seven of 20 patients had more than one abscess. In all, 33 separate abscesses were observed. The diagnosis was based on clinical findings such as malaise, fever, abdominal discomfort, and pain in the right abdomen, haematological and serological anomalies, such as leukocytosis, elevated erythrocyte sedimentation rate, and slightly elevated liver enzymes. The serological investigation included complement fixation, indirect haemagglutination, and latex fixation test; this latter test produced strong reactions in all patients with acute symptoms. The typical ultrasonographic pattern resembled that of a minor echogenic lesion at the time of diagnosis and initiation of therapy. However, in a few acutely ill patients the lesions could not be identified by ultrasonography on first examination, but were clearly identifiable on second investigation on the following days. This finding has not been published previously. It may be observed in a very early stage of the disease only and is, therefore, dependent on rapid diagnosis of amoebiasis. During the follow-up investigations of three months to one year, the majority of abscesses could still be identified.