title: Experience with aspiration in cases of amebic liver abscess in an endemic area.
abstract: The study presented here was performed to evaluate the need for aspiration in patients with amebic liver abscess (ALA). Patients older than 12 years with a diagnosis of ALA based on clinical features, ultrasound results, and positive amebic serology were included in the study (n=144). Serological testing was performed to detect the presence of immunoglobin G antibody against Entamoeba histolytica, and a value of more than 0.4 optical density units was considered positive. All patients were given intravenous metronidazole (500 mg every 8 h) and their clinical progress and need for abscess aspiration was documented. Fever, pain in the upper abdomen, and tender hepatomegaly was seen in 133 (92.3%), 128 (88.8%), and 144 (100%) patients, respectively. Multiple abscesses were seen in 40 (27.7%) patients. Six (4.1%) patients died. Seventy-one (49.3%) patients responded to metronidazole alone. A total of 73 (50.69%) patients required aspiration of the abscess. This study shows that almost 50% of the patients with amebic liver abscess failed to respond to metronidazole and required aspiration.
authors.affiliation: Department of Gastroeneterology and Hepatology, Pushpawati Singhania Research Institute for Liver, Renal and Digestive Diseases, Press Enclave Road, Shiekh Sarai-II, New Delhi 110017, India. khannasudeep@hotmail.com
authors.forename: S
authors.initials: S
authors.lastname: Khanna
authors.forename: D
authors.initials: D
authors.lastname: Chaudhary
authors.forename: A
authors.initials: A
authors.lastname: Kumar
authors.forename: J C
authors.initials: JC
authors.lastname: Vij
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008101:Liver Abscess, Amebic / Q000628:therapy*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D013396:Suction
chemical_list: D000981:Antiprotozoal Agents; D008795:Metronidazole