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A amoebic liver abscess is a type of liver abscess caused by amebiasis. [1] It is the involvement of liver tissue by trophozoites of the organism Entamoeba histolytica and of its abscess due to necrosis.
A large pyogenic liver abscess presumed to be the result of appendicitis. There are several major forms of liver abscess, classified by cause: [3] Pyogenic liver abscess, which is most often polymicrobial, accounts for 80% of hepatic abscess cases in the United States. Amoebic liver abscess due to Entamoeba histolytica accounts for 10% of cases ...
Pulmonary amoebiasis can occur from liver lesions by spread through the blood or by perforation of pleural cavity and lung. It can cause lung abscess, pulmono pleural fistula, empyema lung and broncho pleural fistula. It can also reach the brain through blood vessels and cause amoebic brain abscess and amoebic meningoencephalitis.
In the liver a similar pathological sequence ensues, leading to amebic liver abscesses. The trophozoites can also end up in other organs, sometimes via the bloodstream, sometimes via liver abscess rupture or fistulas. Similarly, when the trophozoites travel to the brain, they can cause amoebic brain abscesses. [26]
For amebic liver abscess: Metronidazole 400 mg three times a day for 10 days; Tinidazole 2g once a day for 6 days is an alternative to metronidazole; Diloxanide furoate 500 mg three times a day for 10 days (or one of the other lumenal amebicides above) must always be given afterwards
To differentiate pyogenic liver abscess from amoebic liver abscess, several features such as subjects with age more than 50 years with lungs involvement, multiple liver abscesses, with amoebic serologic titres less than 1:256 can help to pin down the diagnosis of pyogenic liver abscess.
Entamoeba histolytica is the pathogen responsible for invasive 'amoebiasis' (which includes amoebic dysentery and amoebic liver abscesses). Others such as Entamoeba coli (not to be confused with Escherichia coli ) and Entamoeba dispar [ 3 ] are harmless.
Symptoms can progress to ameboma, fulminant colitis, toxic megacolon, colonic ulcers, leading to perforation, and abscesses in vital organs like liver, lung, and brain. Amoebiasis can be treated with the administration of anti-amoebic compounds, this often includes the use of Metronidazole , Ornidazole , Chloroquine , Secnidazole , Nitazoxanide ...