Unusual multiple large abscesses of the liver: interest of the radiological features and the real-time PCR to distinguish between bacterial and amebic etiologies

Désoubeaux, Guillaume; Chaussade, H.; Thellier, Marc; Poussing, Sophie; Bastides, Frédéric; Bailly, Éric; Lanotte, Philippe; Alison, D.; Brunereau, L.; Bernard, Louis; Chandenier, J.

doi:10.1179/2047773213y.0000000121

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…To investigate further the large distribution of PCT values, we looked at the potential prognostic value of PCT in relation to the clinical presentation. Analysis of the personal data of a patient with a particularly high PCT level (45.66 μg/L) showed that he had a very rare and severe radiological presentation, with 19 large liver abscesses (Desoubeaux et al, 2014). Noteworthy, PCT level rapidly decreased for him after initiation of antiamoebic therapy.…”

Section: Discussionmentioning

confidence: 99%

Is procalcitonin increased in cases of invasive amoebiasis? A retrospective, observational study

Recipon

Piver

Caille

et al. 2015

Diagnostic Microbiology and Infectious Disease

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Procalcitonin (PCT) levels are commonly used for diagnostic guidance in routine bacterial infections. By contrast, little data are currently available regarding PCT in parasitic diseases, and its role in cases of invasive amoebiasis has not yet been described. For this purpose, 35 adult patients with a proven diagnosis of invasive or digestive amoebiasis were included in a 4-year study period. Serum PCT was retrospectively assessed. Results were analysed with regard to the usual inflammatory biomarkers, like C-reactive protein (CRP). PCT was significantly higher in patients with proven invasive amoebiasis than in digestive amoebiasis (mean value: 4.03 μg/L versus 0.07 μg/L, respectively; P < 0.001), but the SD was greater than with CRP, and the effect was less than that demonstrated in bacterial infections. By contrast, PCT was not shown to be elevated during digestive amoebiasis.

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Section: Discussionmentioning

confidence: 99%

Is procalcitonin increased in cases of invasive amoebiasis? A retrospective, observational study

Recipon

Piver

Caille

et al. 2015

Diagnostic Microbiology and Infectious Disease

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“…While the risk of false-positive results can be excluded because of the closed format of qPCR-D and the specificity of the primers and probes used (24), the sensitivity of qPCR-D was not perfect, since 2 of 19 (10.5%) patients were considered to have false-negative results. A first hypothesis is the effect of antiamoebic treatment, with rapid disappearance of the circulating E. histolytica DNA.…”

Section: Discussionmentioning

confidence: 99%

“…Because some key factors of qPCR-V, such as the limit of detection (LOD) and efficiency, were not available, we first evaluated these parameters and compared them to those of another qPCR assay reported by Desoubeaux et al (24), designated qPCR-D below. Oligonucleotide primers Eh-196F (5=-AA ATGGCCAATTCATTCAATGA-3=) and Eh-294R (5=-CATTGGTTACTTGTTAAACACTGTGTG-3=) and the Eh-245 probe (FAM-AGG ATG CCA CGA CAA-black hole quencher 1 [BHQ1]) were designed for the purpose of amplifying a 99-bp fragment of the small-subunit rRNA gene of E. histolytica only (GenBank accession number X64142).…”

Section: Figmentioning

confidence: 99%

Entamoeba histolytica DNA Detection in Serum from Patients with Suspected Amoebic Liver Abscess

Ghelfenstein-Ferreira

Gits-Muselli

Dellière

et al. 2020

J Clin Microbiol

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Amoebic liver abscess (ALA) is regularly seen in travelers or immigrants from tropical countries. The diagnosis relies on liver imaging that is not specific, and the detection of anti-Entamoeba histolytica antibodies, which cannot distinguish acute from former infection. We tested whether E. histolytica DNA detection in serum can improve the diagnosis of ALA. We retrospectively tested available serum samples from patients with ALA and non-ALA liver space-occupying lesions between 01/01/2010 and 11/30/2019. The quantitative PCR (qPCR) assay tested specifically amplifies a 99-bp fragment of the small-subunit rRNA gene of E. histolytica. We analyzed 76 samples (ALA=19; non-ALA=57) from 76 patients collected within 6 days before and after the anti-amoebic treatment. Serum qPCR was positive in 17 of 19 ALA patients and in none of the control patients (sensitivity and specificity were 89.5% and 100%, respectively). In parallel, the sensitivity and specificity of the anti-E. histolytica antibody detection were 100% and 89.5%, respectively. The two false-negative qPCR results may be explained by ongoing metronidazole treatment or a possible persistent seropositivity that is not caused by the current liver abscess. Additionally, out of 12 abscess pus aspirates (ALA=5; non-ALA=7) tested, 5 were qPCR positive and 7 were qPCR negative with concordant results on serum. This study demonstrates that cell-free circulating E. histolytica DNA can be detected in serum in ALA. This may assist in both positive diagnoses and treatment efficacy follow-up. The origin of this circulating DNA remains to be investigated.

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Distribution of common pathogens in patients with pyogenic liver abscess in China: a meta-analysis

Luo

Yang

Tan³

et al. 2016

Eur J Clin Microbiol Infect Dis

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Pyogenic liver abscess (PLA) is a potentially life-threatening disease in many parts of the world, especially in Asia. The aim of this study was to quantify the proportion of common pathogens in patients with PLA in China, using a meta-analysis method based on systematic review of published studies. Several electronic databases were searched to identify the studies reporting the pathogens of PLA. We performed a meta-analysis to calculate the pooled proportion of pathogens and subgroup analysis among the included studies using R 3.1.1 software. In total, 183 studies were included in our final analysis, Klebsiella spp (54 %), Escherichia spp (29 %), Enterobacter spp (9 %), Proteus spp (6 %) and Pseudomonas spp (5 %) comprised the major gram-negative bacteria. Gram-positive bacteria mainly included Staphylococcus spp (13 %), Streptococcus spp (8 %) and Enterococcus spp (7 %). The distribution of pathogens in PLA patients were different in different economic regions in China. The proportion of Klebsiella spp had an upward tendency in recent years compared to other pathogens. In addition, the proportion of common pathogens in PLA patients with diabetes mellitus (DM) were carried out indicating that the dominant pathogens were Klebsiella spp (66 %), Escherichia spp (21 %) and Enterobacter spp (11 %). This meta-analysis showed that the main pathogens of PLA were Klebsiella spp, Escherichia spp, Staphylococcus spp, and Enterobacter spp in China. To ensure a precise estimate of the epidemiology of the pathogens, further large-scale or even a population-based study is needed.

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Unusual multiple large abscesses of the liver: interest of the radiological features and the real-time PCR to distinguish between bacterial and amebic etiologies

Cited by 7 publications

References 20 publications

Is procalcitonin increased in cases of invasive amoebiasis? A retrospective, observational study

Is procalcitonin increased in cases of invasive amoebiasis? A retrospective, observational study

Entamoeba histolytica DNA Detection in Serum from Patients with Suspected Amoebic Liver Abscess

Distribution of common pathogens in patients with pyogenic liver abscess in China: a meta-analysis

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