Amoebic liver abscess differential diagnosis: Difference between revisions
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! rowspan="3" |Other Findings | ! rowspan="3" |Other Findings | ||
|- | |- | ||
! rowspan="2" | Fever | ! rowspan="2" | [[Fever]] | ||
! colspan="2" | Pain | ! colspan="2" | Pain | ||
! rowspan="2" | cough | ! rowspan="2" | [[Cough (patient information)|cough]] | ||
! rowspan="2" | Hepatomegaly | ! rowspan="2" | [[Hepatomegaly]] | ||
! rowspan="2" | Jaundice | ! rowspan="2" | [[Jaundice]] | ||
! rowspan="2" | Weight loss | ! rowspan="2" | [[Weight loss]] | ||
! rowspan="2" | Anorexia | ! rowspan="2" | [[Anorexia]] | ||
! rowspan="2" | Diarrhoea | ! rowspan="2" | [[Diarrhoea]] | ||
or Dysentry | or [[Dysentry]] | ||
! rowspan="2" | Nausea and | ! rowspan="2" | [[Nausea]] and | ||
vomiting | [[vomiting]] | ||
! rowspan="2" | Stool | ! rowspan="2" | [[Stool]] | ||
|- | |- | ||
! Abdominal pain | ! [[Abdominal pain]] | ||
(right upper quadrant pain) | ([[right upper quadrant pain]]) | ||
! Pleuritic pain | ! [[Pleuritic pain]] | ||
|- | |- | ||
|[[Amoebic liver abscess]] | |[[Amoebic liver abscess]] | ||
|[[Entamoeba histolytica]] | |[[Entamoeba histolytica]] | ||
| | | +++ | ||
| | | +++ | ||
| | | +/- | ||
| | | + | ||
| | | ++/- | ||
| | | + | ||
(late stages) | (late stages) | ||
| | | + | ||
(late stages) | (late stages) | ||
| | | + | ||
| | | + | ||
| | | + | ||
| | | | ||
|[[Hypoalbuminemia]] | |[[Hypoalbuminemia]] | ||
( | (+) | ||
| | | | ||
* Ultrasound is the gold standard technique for diagnosing [[amoebic liver abscess]] | * [[Ultrasound]] is the [[Gold standard (test)|gold standard]] technique for diagnosing [[amoebic liver abscess]] | ||
| | | | ||
* | * Responds well to [[chemotherapy]] and rarely require drainage | ||
* Marked male predominance | * Marked male predominance | ||
* More common in developing countries | * More common in developing countries | ||
* [[Sero-positive]] | * [[Seropositive|Sero-positive]] | ||
* Right lobe is more frequently involved | * [[Right lobe of liver|Right lobe]] is more frequently involved | ||
|- | |- | ||
|[[Pyogenic liver abscess]] | |[[Pyogenic liver abscess]] | ||
| Line 68: | Line 68: | ||
* [[Anaerobic]] organisms | * [[Anaerobic]] organisms | ||
* [[Acid-fast bacilli]] | * [[Acid-fast bacilli]] | ||
| | | + | ||
| | | + | ||
| | | ++ | ||
| | | ++ | ||
| | | +/- | ||
| | | +++ | ||
| | | + | ||
(acute loss) | (acute loss) | ||
| | | + | ||
| | | | ||
| | | + | ||
|Pale/dark | |Pale/dark | ||
|[[Hypoalbuminemia]] | |[[Hypoalbuminemia]] | ||
( | (+++) | ||
|Cluster sign | |Cluster sign | ||
* [[CT scan]] shows cluster sign | * [[CT scan]] shows cluster sign | ||
| Line 96: | Line 96: | ||
|Fungal liver abscess | |Fungal liver abscess | ||
|''[[Candida|Candida species]]''<br>[[Aspergillus|Aspergillus species]] | |''[[Candida|Candida species]]''<br>[[Aspergillus|Aspergillus species]] | ||
| | | + | ||
| | | + | ||
| | | +- | ||
| | | + | ||
| | | + | ||
| | | + | ||
| | | + | ||
| | | + | ||
| | | + | ||
| | | + | ||
| | | | ||
| | | | ||
|[[CT]] and [[USG]] findings with four patterns of presentation: | |[[CT]] and [[Ultrasonogram|USG]] findings with four patterns of presentation: | ||
* Wheel-within-a-wheel pattern | * Wheel-within-a-wheel pattern | ||
* Bull’s-eye configuration pattern | * Bull’s-eye configuration pattern | ||
| Line 122: | Line 122: | ||
|[[Echinococcus granulosus]] | |[[Echinococcus granulosus]] | ||
| | | | ||
| | | + | ||
| | | | ||
| | | + | ||
| | | | ||
| | | + | ||
([[Obstructive jaundice]]) | ([[Obstructive jaundice]]) | ||
| | | + | ||
| | | + | ||
| | | | ||
| | | | ||
| Line 141: | Line 141: | ||
c.The ectocyst, a thin, translucent interleaved membrane | c.The ectocyst, a thin, translucent interleaved membrane | ||
|Ultrasound: | |[[Ultrasound]]: | ||
* Cystic to solid-appearing pseudotumors | * [[Cystic]] to [[solid]]-appearing pseudotumors | ||
* Water lily sign | * Water lily sign | ||
* [[Calcification]]s seen peripherally | * [[Calcification]]s seen peripherally | ||
| Line 158: | Line 158: | ||
*[[Alpha 1 antitrypsin deficiency]] | *[[Alpha 1 antitrypsin deficiency]] | ||
*[[Nonalcoholic fatty liver disease]] | *[[Nonalcoholic fatty liver disease]] | ||
| | | + | ||
| | | + | ||
(uncommon) | (uncommon) | ||
| | | | ||
| | | | ||
| | | + | ||
| | | + | ||
| | | ++ | ||
| | | | ||
| | | | ||
| | | ++ | ||
|Pale/Chalky | |Pale/Chalky | ||
| | | | ||
* High levels of [[alpha-fetoprotein|AFP]] in serum | * High levels of [[alpha-fetoprotein|AFP]] in [[serum]] | ||
* Abnormal [[liver function tests]] | * Abnormal [[liver function tests]] | ||
| | | | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Surgery]] | |||
[[Category:Emergency medicine]] | |||
[[Category:Infectious disease]] | |||
[[Category:Hepatology]] | |||
Latest revision as of 20:23, 29 July 2020
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Amoebic liver abscess Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Amoebic liver abscess differential diagnosis On the Web |
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American Roentgen Ray Society Images of Amoebic liver abscess differential diagnosis |
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Risk calculators and risk factors for Amoebic liver abscess differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
Amoebic liver abscess must be differentiated from other diseases that cause fever, abdominal pain, cough, jaundice, hepatomegaly, anorexia, nausea, vomiting, and pale or dark stools such as pyogenic liver abscess, fungal liver abscess, echinococcal cyst, and hepatocellular carcinoma.
Differential Diagnosis
Amoebic liver abscess must be differentiated from:[1][2][3][4][5][6][7][8][9][10]
| Disease | Causes | Signs and Symptoms | Laboratory Findings | Imaging Findings | Other Findings | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Fever | Pain | cough | Hepatomegaly | Jaundice | Weight loss | Anorexia | Diarrhoea
or Dysentry |
Nausea and | Stool | ||||||
| Abdominal pain | Pleuritic pain | ||||||||||||||
| Amoebic liver abscess | Entamoeba histolytica | +++ | +++ | +/- | + | ++/- | +
(late stages) |
+
(late stages) |
+ | + | + | Hypoalbuminemia
(+) |
|
| |
| Pyogenic liver abscess | Bacteria
|
+ | + | ++ | ++ | +/- | +++ | +
(acute loss) |
+ | + | Pale/dark | Hypoalbuminemia
(+++) |
Cluster sign |
| |
| Fungal liver abscess | Candida species Aspergillus species |
+ | + | +- | + | + | + | + | + | + | + | CT and USG findings with four patterns of presentation:
|
| ||
| Echinococcal (hydatid) cyst | Echinococcus granulosus | + | + | + | + | + | Histology: Hydatid cyst with three layers
a.The outer pericyst, which corresponds with compressed and fibrosed liver tissue b.The endocyst, an inner germinal layer c.The ectocyst, a thin, translucent interleaved membrane |
Ultrasound:
|
| ||||||
| Malignancy | + | +
(uncommon) |
+ | + | ++ | ++ | Pale/Chalky |
|
Other symptoms: | ||||||
References
- ↑ Lodhi S, Sarwari AR, Muzammil M, Salam A, Smego RA (2004). "Features distinguishing amoebic from pyogenic liver abscess: a review of 577 adult cases". Trop Med Int Health. 9 (6): 718–23. doi:10.1111/j.1365-3156.2004.01246.x. PMID 15189463.
- ↑ Barbour GL, Juniper K (1972). "A clinical comparison of amebic and pyogenic abscess of the liver in sixty-six patients". Am J Med. 53 (3): 323–34. PMID 5054724.
- ↑ Barnes PF, De Cock KM, Reynolds TN, Ralls PW (1987). "A comparison of amebic and pyogenic abscess of the liver". Medicine (Baltimore). 66 (6): 472–83. PMID 3316923.
- ↑ Conter RL, Pitt HA, Tompkins RK, Longmire WP (1986). "Differentiation of pyogenic from amebic hepatic abscesses". Surg Gynecol Obstet. 162 (2): 114–20. PMID 3945889.
- ↑ Lipsett PA, Huang CJ, Lillemoe KD, Cameron JL, Pitt HA (1997). "Fungal hepatic abscesses: Characterization and management". J Gastrointest Surg. 1 (1): 78–84. PMID 9834333.
- ↑ Pastakia B, Shawker TH, Thaler M, O'Leary T, Pizzo PA (1988). "Hepatosplenic candidiasis: wheels within wheels". Radiology. 166 (2): 417–21. doi:10.1148/radiology.166.2.3275982. PMID 3275982.
- ↑ Mortelé KJ, Ros PR (2001). "Cystic focal liver lesions in the adult: differential CT and MR imaging features". Radiographics. 21 (4): 895–910. doi:10.1148/radiographics.21.4.g01jl16895. PMID 11452064.
- ↑ Suwan Z (1995). "Sonographic findings in hydatid disease of the liver: comparison with other imaging methods". Ann Trop Med Parasitol. 89 (3): 261–9. PMID 7668917.
- ↑ Esfahani F, Rooholamini SA, Vessal K (1988). "Ultrasonography of hepatic hydatid cysts: new diagnostic signs". J Ultrasound Med. 7 (8): 443–50. PMID 3047423.
- ↑ Niron EA, Ozer H (1981). "Ultrasound appearances of liver hydatid disease". Br J Radiol. 54 (640): 335–8. doi:10.1259/0007-1285-54-640-335. PMID 7225721.