Amoebic Liver Abscess

Clinical Description

Amoebic liver abscess is a collection of typically brownish coloured fluid in the liver, occurring often as a single mass in the right lobe and a complication of intestinal infection with Entamoeba histolytica. Lung, heart and brain infections are uncommon sequelae.

Occasionally, pyogenic abscesses may have a similar clinical presentation.

Signs and Symptoms

• Large tender liver.
• Tenderness and/or bulging at right intercostal spaces.
• Jaundice, dullness to percussion on the right lower chest zones with basal crepitation’s amoebic empyema following extension into the chest cavity.
• Peritonitis (uncommon)

Investigations

• Abdominal ultrasound
• Chest X-ray
• FBC
• ESR
• Stool examination
• Abdominal CT scan
• Serology (amoebic antibodies)

Treatment

• Give Metronidazole 800mg 8 hourly for 10 days
• Give oral (preferably after food) or IV (depending on the condition of the patient)
• If necessary, repeat treatment course after 2 weeks

Complications and Referral Criteria

• In cases of large abscesses or superficial abscesses, to the tertiary facility for aspiration under ultrasound guidance.