Parasitic infections
Amoebic liver abscesses
Clinical features
The onset of the disease may be sudden or gradual. Right upper quadrant pain associated with general malaise and weight loss is the most common symptoms on presentation. Pyrexia and sweating occurs in about 60% of patients. Approximately 30% of patientsĀ have diarrhea. Signs may include tender hepatomegaly and, occasionally, jaundice.
Investigation
Full blood examination may show leukocytosis and eosinophilia. Liver function tests are frequently deranged and show a hepatocellular pattern of injury. Amoebic serology and stool cultures are usually positive.Ultrasound with needle aspiration and cultureĀ confirm the diagnosis.
Treatment
Symptomatic measures include analgesics and attention to nutrition and hydration. Antimicrobial therapy is the mainstay of treatment. This may be associated with percutaneous drainage or repeated aspiration if necessary .The antibiotic of choice is metronidazole.