A Giant Amebic Liver Abscess

Takefumi Kamiya, Koshi Oseki, Souiti Sugitani, Takao Iiri
2012 Internal medicine (Tokyo. 1992)  
A 45 year-old man developed abdominal pain, anorexia and malaise. A liver abscess was suspected on abdominal ultrasonography, and the patient was transferred to our hospital. He had taken a family trip to Guam 20 years previously. On admission, a physical examination revealed abdominal tenderness, resistance and jaundice. The laboratory data showed inflammatory signs, an abnormal liver function and hypoproteinemia. Abdominal computed tomography (CT) showed a gigantic hypodense multiseptated
more » ... ess measuring 168 mm×122 mm (Picture A) occupying the entire right lobe with an elevation of the diaphragm to the 4th intercostal space (Picture B) and continuation to a subphrenic abscess (Picture B). Percutaneous drainage was attempted; however, the presence of trophozoites of Entamoeba histolytica in the drained abscess was proven on the 4th day (Picture C), and serologically confirmed on the 9th day of hospitalization. Antibiotics and Fresh frozen plasma (FFP) were administered without any effect and they were later replaced with metronidazole. The patient developed DIC, thrombosis of the inferior venae cava and the portal vein and died from multi-organ failure one month later. The authors state that they have no Conflict of Interest (COI ). Reference 1. Haque R, Kabir M, Noor Z, et al. Diagnosis of amebic liver abscess and amebic colitis by detection of Entamoeba histolytica DNA in blood, urine, and salivary by real-time PCR assay. J Clin Microbiol
doi:10.2169/internalmedicine.51.8489 pmid:23154737 fatcat:a3nyamib6vh2vejznzu5qu662i