View source for Amoebic liver abscess

{{Infobox medical condition (new)
| name            = Amoebic hepatic abscess
| synonyms        =
| image           = Liver containing amebic abscess, gross pathology 3MG0042 lores.jpg
| caption         = Gross pathology of liver containing amoebic abscess
| pronounce       =
| field           =
| symptoms        =
| complications   =
| onset           =
| duration        =
| types           =
| causes          =
| risks           =
| diagnosis       =
| differential    =
| prevention      =
| treatment       =
| medication      =
| prognosis       =
| frequency       =
| deaths          =
}}

A '''amoebic liver abscess''' is a type of [[liver abscess]] caused by [[amebiasis]].<ref name="NespolaBetz2015">{{cite journal |last1=Nespola |first1=Benoît |last2=Betz |first2=Valérie |last3=Brunet |first3=Julie |last4=Gagnard |first4=Jean-Charles |last5=Krummel |first5=Yves |last6=Hansmann |first6=Yves |last7=Hannedouche |first7=Thierry |last8=Christmann |first8=Daniel |last9=Pfaff |first9=Alexander W. |last10=Filisetti |first10=Denis |last11=Pesson |first11=Bernard |last12=Abou-Bacar |first12=Ahmed |last13=Candolfi |first13=Ermanno |title=First case of amebic liver abscess 22 years after the first occurrence |journal=Parasite |date=2015 |volume=22 |pages=20 |doi=10.1051/parasite/2015020 |pmid=26088504 |pmc=4472968 }}</ref>  It is the involvement of liver tissue by trophozoites of the organism ''[[Entamoeba histolytica]]'' and of its abscess due to necrosis.

==Presentation==
Approximately 90% of patients with ''E histolytica'' are asymptomatic.<ref name="auto">{{cite journal |last1=Wuerz |first1=Terry |last2=Kane |first2=Jennifer B |last3=Boggild |first3=Andrea K |last4=Krajden |first4=Sigmund |last5=Keystone |first5=Jay S |last6=Fuksa |first6=Milan |last7=Kain |first7=Kevin C |last8=Warren |first8=Ralph |last9=Kempston |first9=John |last10=Anderson |first10=Joe |title=A Review of Amoebic Liver Abscess for Clinicians in a Nonendemic Setting |journal=Canadian Journal of Gastroenterology |date=2012 |volume=26 |issue=10 |pages=729–733 |doi=10.1155/2012/852835 |pmid=23061067 |pmc=3472914 |doi-access=free }}</ref> The two most common manifestations of ''E histolytica'' include [[colitis]] (bloody stool with mucus, abdominal pain, and/or diarrhea), and discovery of a liver abscess on imaging.<ref name="auto"/> Liver abscesses commonly present as right upper quadrant abdominal pain and fever, with worsening features associated with abscess rupture.<ref name="auto"/>

[[File:Parasite150029-fig1 First case of amebic liver abscess 22 years after the first occurrence.tif|thumb|Magnetic resonance cholangiopancreatography (MRC) image showing a voluminous and heterogeneous collection in the left liver lobe (amoebic abscess)]]

===Symptoms===
* Pain right [[hypochondrium]] referred to the right shoulder
* [[Pyrexia]] (100.4 F)
* Profuse sweating and rigors
* Loss of weight
* Earthy complexion

===Signs===
* [[Pallor]]
* Tenderness and rigidity in right hypochondrium
* Palpable liver
* [[wikt:intercostal|Intercostal]] tenderness
* Basal lung signs

==Diagnosis==
Diagnosis is primarily made by identifying stool ova and parasites on stool antigen testing in the presence of colitis, or ''E histolytica'' serology.<ref name="auto"/>
* Blood [[ceruloplasmin]]
* [[Haemoglobin]] estimation
* [[human feces|Stool]]s examination ([[trophozoite]]s and [[cyst]]s)
* [[Radiography]]
* [[Needle aspiration biopsy|Aspiration]] exploratory
* [[Medical ultrasonography]] and [[CT scan]]ning
* [[Sigmoidoscopy]]
* [[Liver function tests]]
* [[Serological]] tests
==Treatment==
Although medical management using long courses of antibiotics have proven to be successful, Drainage of the abscess is the mainstay treatment.
<ref>{{cite book |title=Harrison's Principles of Internal Medicine |date=22 October 2019 |publisher=Mc Graw Hill |isbn=978-1-26-045535-9 |page=402 |edition=20}}</ref>

==Research==
[[File:Parasite150072-fig2 Role of neutrophils in rodent amebic liver abscess.png|thumb|Role of [[neutrophil]]s in rodent amebic liver abscess <ref name="Campos2016"/>]]

Due to the difficulty of exploring host and amebic factors involved in the pathogenesis of amebic liver abscess in humans, most studies have been conducted with animal models (e.g., [[mice]], [[gerbils]], and [[hamsters]]). Histopathological findings revealed that the chronic phase of amebic liver abscess in humans corresponds to lytic or liquefactive [[necrosis]], whereas in rodent models there is granulomatous [[inflammation]]. However, the use of [[animal models]] has provided important information on molecules and mechanisms of the host/parasite interaction in amebic liver abscess.<ref name="Campos2016">{{cite journal |last1=Campos-Rodríguez |first1=Rafael |last2=Gutiérrez-Meza |first2=Manuel |last3=Jarillo-Luna |first3=Rosa Adriana |last4=Drago-Serrano |first4=María Elisa |last5=Abarca-Rojano |first5=Edgar |last6=Ventura-Juárez |first6=Javier |last7=Cárdenas-Jaramillo |first7=Luz María |last8=Pacheco-Yepez |first8=Judith |title=A review of the proposed role of neutrophils in rodent amebic liver abscess models |journal=Parasite |date=2016 |volume=23 |pages=6 |doi=10.1051/parasite/2016006 |pmid=26880421 |pmc=4754534 }}</ref>
{{clear}}

==References==
{{reflist}}

== External links ==
{{Medical resources
|  DiseasesDB     =
|  ICD10          = {{ICD10|A|06|4|a|00}}
|  ICD9           = {{ICD9|006.3}}
|  ICDO           =
|  OMIM           =
|  MedlinePlus    = 000211
|  eMedicineSubj  = article
|  eMedicineTopic = 183920
|  MeshID         = D008101
}}
{{Gastroenterology}}
{{Amoebozoa diseases}}

[[Category:Intestinal infectious diseases]]