Amoebic abscess in the cirrhotic liver

Though amoebic liver abscess and liver cirrhosis occur very commonly in hospital practice in the tropics, they have not to the knowledge of the present authors hitherto been reported to occur simultaneously in the same patient. The patient described here, who had clear-cut clinical and histological features of chronic liver cirrhosis with portal hypertension and ascites, presented somewhat acutely with liver pain and an amoebic liver abscess that contained 'chocolate sauce' on needle aspiration. The amoebic abscess, although, no doubt, superimposed on chronic irreversible cirrhosis, rapidly regressed on metronidazole therapy. The infrequency with which liver abscess and liver cirrhosis coexist cannot be satisfactorily explained. It is probable, however, that extensive scarring in the liver may prevent entamoeba histolytica from thriving.