Amoebic liver abscess diagnostic approach
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
Diagnostic approach includes laboratory methods like microscopy, culture, antigen, and antibody detection and radiologic method like CT scan, MRI, and ultrasonography.
Diagnostic Approach
Diagnostic approach for the patients with amoebic liver abscess[1]
| Diagnosis of amoebic liver abscess | |||||||||||||||||||||||||||||||||||||||||||||||
| Signs and symptoms(a) Fever, abdominal pain, point tenderness over the liver, hepatomegaly, weight loss History Travel to endemic areas, immigrant from endemic areas, having had dysentery within last years, gender (male/female:9/1 | |||||||||||||||||||||||||||||||||||||||||||||||
| Laboratory diagnosis(LD) and Radiologic Methods (RM) (US, CT or MRI) | |||||||||||||||||||||||||||||||||||||||||||||||
| LD negative and RM negative:Flow | LD negative and RM positive:aspiration, if possible(b) | LD positive and RM positive: chemotherapy / surgical treatment | |||||||||||||||||||||||||||||||||||||||||||||
| Pyogenic abscesses Neoplasia (hepatocellular carcinoma) Cysticercosis Cystic echinococcosis | Amoebic liver abscess | ||||||||||||||||||||||||||||||||||||||||||||||
Laboratory Diagnosis (LD)
- Microscopy; abscess fluid; sterile, odorless, brown or yellow liquid
- Culture
- Antigen detection in saliva, serum (ELISA)
- Antibody detection in abscess fluid/pus (ELISA, IHA)
- PCR
a. Acute clinical manifestations are associated with multiple amoebic abscess
b. Aspiration contraindicated for cystic echinococcosis
Adopted from Clinical Microbiology Reviews Clin Microbiol Rev. 2003 Oct; 16(4): 713–729.