Amoebic liver abscess natural history, complications and prognosis
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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
If left untreated, amoebic liver abscess may disseminate to other organs leading to death.[1]The complications of amoebic liver abscess develop due to rupture of the abscess into the abdomen or chest cavity. The complications include peritonitis, pericarditis / pneumopericardium / tamponade, pleuropulmonary / pneumothorax (the right lung and pleural space are frequently effected because of their proximity to the liver), obstructive jaundice, bacterial superinfection, cutaneous fistulization of chest and abdominal wall, inferior vena cava obstruction, hemobilia / thoracobilia, internal fistulization, systemic inflammatory response syndrome, Venous and arterial thrombosis.[2][3][4][5][6][7][8][9][10][11][12][13]Prognosis is good with treatment. Patients who are treated have high chance of complete recovery or minor complications.[14]
Natural History
If left untreated, amoebic liver abscess may disseminate to other organs leading to death.[1]
Complications
The complications of amoebic liver abscess develop due to rupture of the abscess into the abdomen or chest cavity. The complications include:[2][3][4][5][6][7][8][9][10][11][12][13]
- Peritonitis
- Pericarditis / pneumopericardium / tamponade
- Pleuropulmonary/pneumothorax (the right lung and pleural space are frequently effected because of their proximity to the liver)
- Obstructive jaundice
- Bacterial superinfection
- Cutaneous fistulization of chest and abdominal wall
- Inferior vena cava obstruction
- Hemobilia/thoracobilia
- Internal fistulization
- Systemic inflammatory response syndrome
- Venous and arterial thrombosis
Prognosis
- Prognosis is good with treatment. Patients who are treated have the high chance of complete recovery or minor complications.
- If left untreated, abscess ruptures leading to death.
Poor prognostic factors include:[14]
- Multiple abscesses
- Abscess volume greater than 500 ml
- Elevated right hemidiaphragm
- Pleural effusion on chest radiography
- Anemia (hemoglobin <10g/dl)
- Albumin <2g/dl
- Bilirubin level >3.5mg/dl
- Hypoalbuminemia (serum albumin <2.0g/dl)
- Diabetes
- Encephalopathy
References
- ↑ 1.0 1.1 Kurt Ö, Aktaş N, Çalışkan C, Karatuna O, Aygün H, Akyar I (2015). "[Amoebic liver abscess in a patient initially diagnosed with pneumonia: case report and discussion of relevant literature]". Turkiye Parazitol Derg. 39 (1): 70–4. doi:10.5152/tpd.2015.3608. PMID 25917589.
- ↑ 2.0 2.1 Meng XY, Wu JX (1994). "Perforated amebic liver abscess: clinical analysis of 110 cases". South Med J. 87 (10): 985–90. PMID 7939926.
- ↑ 3.0 3.1 Peres LC, Saggioro FP, Dias LB, Alves VA, Brasil RA, Luiz VE; et al. (2008). "Infectious diseases in paediatric pathology: experience from a developing country". Pathology. 40 (2): 161–75. doi:10.1080/00313020701816357. PMID 18203038.
- ↑ 4.0 4.1 Salles JM, Moraes LA, Salles MC (2003). "Hepatic amebiasis". Braz J Infect Dis. 7 (2): 96–110. PMID 12959680.
- ↑ 5.0 5.1 Archampong EQ (1972). "Peritonitis from amoebic liver abscess". Br J Surg. 59 (3): 179–81. PMID 5014518.
- ↑ 6.0 6.1 Sarda AK, Bal S, Sharma AK, Kapur MM (1989). "Intraperitoneal rupture of amoebic liver abscess". Br J Surg. 76 (2): 202–3. PMID 2702459.
- ↑ 7.0 7.1 Ganesan TK, Kandaswamy S (1975). "Amebic pericarditis". Chest. 67 (1): 112–3. PMID 1235314.
- ↑ 8.0 8.1 Ibarra-Pérez C (1981). "Thoracic complications of amebic abscess of the liver: report of 501 cases". Chest. 79 (6): 672–7. PMID 7226956.
- ↑ 9.0 9.1 Shamsuzzaman SM, Hashiguchi Y (2002). "Thoracic amebiasis". Clin Chest Med. 23 (2): 479–92. PMID 12092041.
- ↑ 10.0 10.1 Adeyemo AO, Aderounmu A (1984). "Intrathoracic complications of amoebic liver abscess". J R Soc Med. 77 (1): 17–21. PMC 1439560. PMID 6699845.
- ↑ 11.0 11.1 Lyche KD, Jensen WA (1997). "Pleuropulmonary amebiasis". Semin Respir Infect. 12 (2): 106–12. PMID 9195675.
- ↑ 12.0 12.1 Lyche KD, Jensen WA, Kirsch CM, Yenokida GG, Maltz GS, Knauer CM (1990). "Pleuropulmonary manifestations of hepatic amebiasis". West J Med. 153 (3): 275–8. PMC 1002529. PMID 2219891.
- ↑ 13.0 13.1 Takhtani D, Kalagara S, Trehan MS, Chawla Y, Suri S (1996). "Intrapericardial rupture of amebic liver abscess managed with percutaneous drainage of liver abscess alone". Am J Gastroenterol. 91 (7): 1460–2. PMID 8678020.
- ↑ 14.0 14.1 Sharma MP, Dasarathy S, Verma N, Saksena S, Shukla DK (1996). "Prognostic markers in amebic liver abscess: a prospective study". Am J Gastroenterol. 91 (12): 2584–8. PMID 8946991.