Amebic Liver Abscess in Israeli Travelers: A Retrospective Study

Abstract

Abstract. Amebic liver abscess (ALA) is endemic in developing countries. The epidemiology and clinical characteristics of the disease in developing countries are well described. Travelers from nonendemic countries can serve as a model for the natural history of ALA. Currently, the available literature on travelers is limited. This is a retrospective observational study on Israeli travelers diagnosed with ALA. Data regarding travel history, clinical presentation, imaging, and treatment were collected and analyzed. Among 6,867 ill returning Israeli travelers, amebiasis was diagnosed in 53 travelers (0.77%), of whom 14 were with ALA (0.2%). Twelve ALA cases (86%) had an exposure in the Indian subcontinent. The male to female ratio was 1:1, with no significant clinical differences between the sexes. The average lag period between exposure and onset of symptoms was 17.1 months. The lack of male predominance and the prolonged lag period may imply that behavioral factors are pivotal in the development of ALA. Larger case series of travelers are required.

Morphological Characteristics of Liver Abscesses According its Etiology

“…However, the real number of Entamoeba infected subjects who develop AHA, is unknown. AHA has been reported following travels to endemic areas for very brief periods (4 days) (Anesi & Gluckman, 2015;Lachish et al, 2016).…”

Simultaneous infection of amoebic liver abscess and hepatitis A infection in a young adult in an endemic region

“…Amoebic liver abscess is the most common extraintestinal manifestation caused due to movement of amebae through the portal venous system. [ 3 ] It is clinically presented within 8–20 weeks of exposure,[ 4 ] with fever (38.5–39.5°C) and right upper quadrant pain. [ 5 ] Hepatomegaly and liver tenderness are commonly observed on physical examination, with less than 10% of cases having jaundice.…”

Importation of Entamoeba histolytica and predominance of Klebsiella pneumoniae in liver abscesses: a 7-year retrospective cohort study from the United Arab Emirates

“…A study from Saudi Arabia and the UK found that all patients with ALA were either from or had recently travelled to the Indian subcontinent [ 11 ]. Likewise, a study on Israeli travellers found that the vast majority of them had travelled to the Indian subcontinent before the onset of symptoms [ 17 ]. Recent data from the United Nations Department of Economic and Social Affairs indicate that migrants comprise a staggering 87.9% of UAE’s total population [ 18 ].…”