title: A case of amoebic liver abscess complicated by a gastric fistula cured with oral medication only.
abstract: A 26-year-old man was admitted to our hospital because of a high-grade fever and abdominal pain. A blood test showed marked inflammation. Enhanced computed tomography (CT) showed an 8.0×6.0cm cystic lesion in the left hepatic lobe. Esophagogastroduodenoscopy showed a huge egg-yolk-like mass in the gastric submucosa in the lesser curvature of the gastric body from the gastric angle. There were 3 ulcers on the mass, out of which milky pus flowed. Trophozoites of Entamoeba histolytica were detected from cultures of the liver abscess and a biopsy of the gastric ulcers. The amoebic dysentery antibody titer was increased 1600 times. An amoebic liver abscess complicated by a gastric fistula was diagnosed. As therapy, oral metronidazole was administered for 2 weeks without percutaneous drainage. The systemic inflammatory findings improved immediately and the abscess decreased markedly in size.
authors.affiliation: Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine.
authors.forename: Norifumi
authors.initials: N
authors.lastname: Takahashi
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Arakawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sunose
authors.forename: Osamu
authors.initials: O
authors.lastname: Totsuka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Toya
authors.forename: Izumi
authors.initials: I
authors.lastname: Takeyoshi
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D005747:Gastric Fistula / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D008101:Liver Abscess, Amebic / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage*
chemical_list: D000981:Antiprotozoal Agents; D008795:Metronidazole