An unusual presentation of an amoebic liver abscess: the story of an unwanted souvenir

Swaminathan, Vikram; O’Rourke, Joanne; Gupta, Rashmi; Kiire, C.F.

doi:10.1136/bcr-2012-006964

Cited by 6 publications

(7 citation statements)

References 10 publications

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“…Clinical manifestation of intestinal or extraintestinal amoebiasis several years after exposure is rather uncommon, with most patients reporting typical GI-symptoms like bloody diarrhea and pan-abdominal pain 8–20 weeks after returning from endemic countries. However, overt manifestation of invasive amoebiasis years or even decades after traveling to endemic regions has been reported [ 9 , 16 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…In developed countries, serological testing (e.g. ELISA, immunofluorescence testing) remains the standard of care for securing the correct diagnosis [ 16 ]. Diagnosis of amoebic liver abscess is usually supported by imaging studies, namely abdominal ultrasound, contrast-enhanced ultrasound (CEUS)—where available—and high-resolution computed tomography to detect local extent of disease as well as infection-associated complications [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Development of amoebic liver abscess in early pregnancy years after initial amoebic exposure: a case report

et al. 2020

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Background Infection with Entamoeba histolytica and associated complications are relatively rare in developed countries. The overall low prevalence in the Western world as well as the possibly prolonged latency period between infection with the causing pathogen and onset of clinical symptoms may delay diagnosis of and adequate treatment for amoebiasis. Amoebic liver abscess (ALA) is the most common extraintestinal manifestation of invasive amoebiasis. Pregnancy has been described as a risk factor for development of invasive amoebiasis and management of these patients is especially complex. Case presentation A 30-year-old Caucasian woman in early pregnancy presented to our emergency department with abdominal pain alongside elevated inflammatory markers and liver function tests. Travel history revealed multiple journeys to tropic and subtropic regions during the past decade and a prolonged episode of intermittently bloody diarrhea during a five month stay in Indonesia seven years prior to admission. Sonographic and magnetic resonance imaging revealed a 5 × 4 cm hepatic abscess. After ultrasound-guided transcutaneous liver drainage, both abscess fluids and blood cultures showed neither bacterial growth nor microscopic signs of parasitic disease. Serological testing confirmed an infection with Entamoeba histolytica, which was treated with metronidazole, followed by eradication therapy with paromomycin. Subsequent clinical, laboratory and imaging follow-up exams showed regression of the ALA. In addition, the pregnancy completed without complications and a healthy baby boy was born 7 months after termination of treatment. Conclusions This case of invasive amoebiasis in early pregnancy outside of endemic regions and several years after exposure demonstrates the importance of broad differential diagnostics in the context of liver abscesses. The complex interdisciplinary decisions regarding the choice of imaging techniques as well as interventional and antibiotic therapy in the context of pregnancy are discussed. Furthermore, we present possible explanations for pregnancy as a risk factor for an invasive course of amoebiasis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development of amoebic liver abscess in early pregnancy years after initial amoebic exposure: a case report

et al. 2020

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“…There have been two recent case reports of amoebic liver abscess in older people 4 5. Both mention acute confusion as a presenting feature and fully discuss problems of diagnosis and management but emphasise these aspects.…”

Section: Discussionmentioning

confidence: 99%

A Lilliputian army under the floorboards: persistent delirium with complete though prolonged recovery

Wakefield¹,

Thompson²,

Bruce

2014

BMJ Case Reports

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We report the case of an 83-year-old man who presented with a history of fluctuating delirium of insidious onset, secondary to an amoebic liver abscess more than 30 years after acute exposure. We describe a 2-year clinical journey that started with a fall and was additionally complicated by severe weight loss and acute kidney injury (AKI). The likely prognosis for such a combination of comorbidities in an older person is for lasting morbidity, institutionalisation and significant mortality. However, the case demonstrates that with timely assessment and care complete recovery is possible though it may take many months. It reminds us of the catalytic implications of falls for older persons and to maintain a differential diagnostic approach to delirium of insidious onset avoiding misdiagnosis as dementia with which it may be associated. Our case report includes extracts from the patient's own account providing added insight into such experiences.

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“…Liver abscesses carry a mortality rate of 20–60% even with appropriate medical-surgical management [ 5 ]. The diagnosis of Liver Abscess is based on, Stool-ova, cyst, Blood-culture, sensitivity, USG-whole abdomen [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Ayurvedic management of amoebic liver abscess-a case report

Mishra¹,

Kajaria²

2022

Journal of Ayurveda and Integrative Medicine

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An unusual presentation of an amoebic liver abscess: the story of an unwanted souvenir

Cited by 6 publications

References 10 publications

Development of amoebic liver abscess in early pregnancy years after initial amoebic exposure: a case report

Development of amoebic liver abscess in early pregnancy years after initial amoebic exposure: a case report

A Lilliputian army under the floorboards: persistent delirium with complete though prolonged recovery

Ayurvedic management of amoebic liver abscess-a case report

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