Amebic liver abscess--rare need for percutaneous treatment modalities.
BACKGROUND
Given the often unspecific symptoms of amebic liver abscess, an analysis was done to recognize the most common patterns of presentation. Since treatment recommendations are still inconsistent comparing conservative and interventional treatment modalities, we evaluated treatment modalities in our patients.


METHODS
A retrospective case series of all patients with confirmed amebic liver abscess was conducted. Age, sex, country of origin or travel, symptoms, and physical and laboratory findings were recorded. Particular attention was given to the need for interventional measures.


RESULTS
62 patients were reviewed, and nearly all of them (95%) had a travel history. The most common findings were fever (97%), abdominal pain (95%), and hepatomegaly (79%). 11% still had no amebic antibodies on presentation but an increase in the follow-up examinations. In 5% needle aspiration was performed to allow differentiation between amebic and pyogenic etiology. Metronidazole alone quickly cleared symptoms in 92% of the patients. In 8% only, there was a therapeutic need for interventional procedures (3% already ruptured, 5% large abscess formation with the danger of rupture).


CONCLUSIONS
In travelers with fever, abdominal pain, and hepatomegaly amebic liver abscess must be considered. Medical treatment with metronidazole is effective in more than 90%. Only in very few cases there is a need for invasive therapeutic modalities.
Weinke
Thomas
T
Klinikum Ernst von Bergmann, Medizinische Klinik (Gastroenterologie, Infektiologie), Charlottenstrasse 72, D-14467 Potsdam, Germany. tweinke@klinikumevb.de
Grobusch
M P
MP
Güthoff
W
W
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D005260:Female; D005334:Fever / Q000209:etiology; D005858:Germany; D006529:Hepatomegaly / Q000209:etiology; D006801:Humans; D008101:Liver Abscess, Amebic / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D013396:Suction; D014195:Travel
D000890:Anti-Infective Agents; D008795:Metronidazole