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Extra-intestinal amebiasis: clinical presentation in a non-endemic setting

S Thorsen1, J Rønne-Rasmussen, E Petersen

  • 1Department of Infectious Diseases, Hvidovre Hospital, Denmark.

Scandinavian Journal of Infectious Diseases
|January 1, 1993
PubMed
Summary
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Extra-intestinal amebiasis, often presenting as amebic liver abscesses, can occur in non-endemic areas. Early diagnosis and metronidazole treatment are crucial for favorable outcomes in patients with Entamoeba histolytica infection.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Clinical Medicine

Background:

  • Extra-intestinal amebiasis is uncommon in non-endemic regions like Denmark.
  • Entamoeba histolytica is the causative agent, often leading to liver abscesses.
  • Understanding the clinical presentation is key for timely diagnosis.

Purpose of the Study:

  • To define the clinical profile of extra-intestinal amebiasis in a non-endemic setting.
  • To identify key diagnostic features and challenges.
  • To evaluate treatment response.

Main Methods:

  • Retrospective analysis of 37/38 patients with high Entamoeba histolytica titers.
  • Inclusion criteria: reciprocal titers >= 512.
  • Clinical data review including symptoms, imaging, and treatment outcomes.

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Main Results:

  • 24 patients had extra-intestinal amebiasis, all with amebic liver abscesses confirmed by ultrasonography.
  • Fever (91%) was the most common symptom; abdominal pain/tenderness was absent in 22%.
  • Pulmonary involvement (45%) was noted; liver abscesses were the sole manifestation.

Conclusions:

  • Extra-intestinal amebiasis in non-endemic areas presents primarily as amebic liver abscesses.
  • Atypical presentations, including lack of abdominal symptoms, are common.
  • Metronidazole is effective, but initial misdiagnosis is frequent.