[Delayed relapses of hepatic amoebiasis initially cured by metronidazole: 2 cases (author's transl)]

Two cases of hepatic amoebic abscesses are reported as having relapsed--one three times, the other twice--after from several weeks to several months of apparent cure by mitronidazole, without recontamination. The following hypothesis can be eliminated: resistance of E. histolytica to metronidazole, poor absorption or faulty diffusion of the drug, its possible inactivation. The persistance of amoebae in the digestive tract, even if they are not detected, seems probable however: either because they are situated in such a way as to be inaccessible to the active metabolities of the metronidazole or because the intra-luminal concentration of these metabolites is not sufficient. The fact that the intestinal parasitism repeatedly leads to the constitution of successive hepatic abscesses in the same person presupposes the privileged anatomic situation of a colonic ulceration which brings about reiterated dissemination through the portal veinous system.