[PARASITARY INFECTIONS OF THE LIVER]
In Perú three are the parasites which affect frequently the liver: Entamoeba histolytica, Echinococcus granulosus and hepatic Fasciola.Amebic liver abscess can start acutely or insidiously with fever and right upper quadrant abdominal pain, with or without liver or intercostal tenderness. The main complications are thoracic, peritoneal or pericardial extension (left lobe abscess). Diagnosis by images study and serology techniques are effective. Currently, Metronidazole is the treatment of choice.Hydatid liver cyst is usually asymptornatic until it produces a mass effect, allergic reactions or a cyst infection occurs as a result of rupture of the cyst to the billary ducts. Rupture to the peritoneum produces secondary seeding with protoscolices which develop into multiple intraabdominal cysts. Study techniques by images and serology methods are also very helpful for diagnosis. Surgery is the most successful treatment but there is also the possibility of medical treatment with Albendazole or a combination of both.Hepatic fascioliasis can be asymptornatic or produce fever, right upper quadrant abdominal pain and hypereosinophilia during the invasive phase, or billary tract obstruction during the chronic phase, which sometimes is only diagnosed during surgical operation. Hemobilia and biliary cirrhosis have been described as complications. During the invasive phase it is based y serological methods, and during the chronic phase diagnosis is made by detection of parasite's eggs in stools. Presently, the treatment of choice is with Triclabendazole.
Legua P
Pedro
DR