Amoebic Liver Abscess: A Complete Overview in Tertiary Care Centre

摘要

Introduction: Amoebiasis is defined as human infection with protozoan parasite, Entamoeba histolytica regardless of the clinical outcome. It commonly resides in large intestine but can invade to other organs. Amoebic Liver Abscess (ALA) is the most common complication of invasive amoebiasis.Aim: To study various aspects of ALA like demographic profiles, clinical features, radiological and laboratory findings and treatment.Materials and Methods: A cross-sectional study was performed in the Department of Microbiology, Maulana Azad Medical College, New Delhi, India, from October 2012 to April 2014. Pus, blood and stool samples were taken from each patient after taking informed consent and examined for trophozoite by microscopy, IgG antibody and antigen of Entamoeba histolytica by ELISA respectively. The results were presented as mean for quantitative variables and percentages for qualitative data. Calculations were done using Microsoft Excel software.Results: Total 65 patients with age more than 18 year were enrolled in the study out of which 39 cases (60%) were diagnosed as ALA. The age ranged from 18 to 90 years (mean age 37.1 year). Male patients were dominated over female. About 74.3% patients were addicted to alcohol. Most patients had acute presentation. Pain in abdomen and fever were the most common symptoms observed (97.4% and 94.8% respectively). The right lobe was involved in 76.9% cases. Solitary abscess was found in 82.0% cases out of which 64.1% were in right lobe. Volume of abscess ranged between 70 cc and as much as 1200 cc. Volume less than 300 cc was seen in 17 cases (43.5%) and more than 300 cc was seen in 22 cases (56.5%). Pleural effusion and intra peritoneal rupture were the two complications (28.2% and 10.2%) found in this study. All patients were treated successfully with or without help of percutaneous intervention.Conclusion: ALA presents itself through various non specific symptoms and signs. Confirmation of diagnosis is made possible with the help of radiological and microbiological methods. Prompt diagnosis and treatment can markedly reduce the complication and mortality.