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Amebic liver abscess in children

Z Nazir1, F Moazam

  • 1Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.

The Pediatric Infectious Disease Journal
|November 1, 1993
PubMed

Insights

Amebic liver abscess in children is rare but treatable. Early diagnosis and treatment with metronidazole, alongside abscess aspiration, led to no deaths in a pediatric study.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Hepatology

Background:

  • Amebic liver abscess (ALA) is a significant cause of morbidity and mortality globally.
  • Pediatric ALA cases are infrequently reported, necessitating further research into their unique clinical presentations and outcomes.

Purpose of the Study:

  • To describe the clinical features, diagnosis, management, and outcomes of amebic liver abscess in children.
  • To identify factors contributing to successful treatment of pediatric ALA.

Main Methods:

  • Retrospective case series of 24 children diagnosed with ALA between November 1987 and October 1992.
  • Diagnosis confirmed via indirect hemagglutination titers and liver ultrasonography.
  • Treatment involved metronidazole and, in select cases, abscess aspiration.

Main Results:

  • The most common symptoms were high-grade fever and right upper quadrant pain, with tender hepatomegaly.
  • Leukocytosis and elevated erythrocyte sedimentation rate were frequent findings.
  • Solitary abscesses were predominant (22/24), and jaundice was absent in all pediatric patients.
  • No deaths occurred despite a median delay of 15 days in presentation.

Conclusions:

  • Pediatric ALA presents differently from adult cases, often without jaundice or significant liver enzyme derangement.
  • A high index of suspicion, prompt metronidazole therapy, and judicious abscess aspiration are crucial for favorable outcomes.
  • Effective management can significantly reduce the morbidity and mortality associated with pediatric ALA.

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