Amoebic liver abscess laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Laboratory tests consistent with diagnosis of [[amoebic liver abscess]] include [[complete blood count]], [[ESR]], [[C-reactive protein]], [[liver function tests]], and stool examination.<ref name="pmid14557296">{{cite journal| author=Tanyuksel M, Petri WA| title=Laboratory diagnosis of amebiasis. | journal=Clin Microbiol Rev | year= 2003 | volume= 16 | issue= 4 | pages= 713-29 | pmid=14557296 | doi= | pmc=207118 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14557296 }} </ref><ref name="pmid14629771">{{cite journal| author=Blessmann J, Binh HD, Hung DM, Tannich E, Burchard G| title=Treatment of amoebic liver abscess with metronidazole alone or in combination with ultrasound-guided needle aspiration: a comparative, prospective and randomized study. | journal=Trop Med Int Health | year= 2003 | volume= 8 | issue= 11 | pages= 1030-4 | pmid=14629771 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14629771 }} </ref><ref name="pmid8265284">{{cite journal| author=Nazir Z, Moazam F| title=Amebic liver abscess in children. | journal=Pediatr Infect Dis J | year= 1993 | volume= 12 | issue= 11 | pages= 929-32 | pmid=8265284 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8265284 }} </ref><ref name="pmid3782753">{{cite journal| author=Thompson JE, Glasser AJ| title=Amebic abscess of the liver. Diagnostic features. | journal=J Clin Gastroenterol | year= 1986 | volume= 8 | issue= 5 | pages= 550-4 | pmid=3782753 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3782753 }} </ref> | Laboratory tests consistent with diagnosis of [[amoebic liver abscess]] include [[complete blood count]], [[ESR]], [[C-reactive protein]], [[liver function tests]], and [[stool examination]].<ref name="pmid14557296">{{cite journal| author=Tanyuksel M, Petri WA| title=Laboratory diagnosis of amebiasis. | journal=Clin Microbiol Rev | year= 2003 | volume= 16 | issue= 4 | pages= 713-29 | pmid=14557296 | doi= | pmc=207118 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14557296 }} </ref><ref name="pmid14629771">{{cite journal| author=Blessmann J, Binh HD, Hung DM, Tannich E, Burchard G| title=Treatment of amoebic liver abscess with metronidazole alone or in combination with ultrasound-guided needle aspiration: a comparative, prospective and randomized study. | journal=Trop Med Int Health | year= 2003 | volume= 8 | issue= 11 | pages= 1030-4 | pmid=14629771 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14629771 }} </ref><ref name="pmid8265284">{{cite journal| author=Nazir Z, Moazam F| title=Amebic liver abscess in children. | journal=Pediatr Infect Dis J | year= 1993 | volume= 12 | issue= 11 | pages= 929-32 | pmid=8265284 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8265284 }} </ref><ref name="pmid3782753">{{cite journal| author=Thompson JE, Glasser AJ| title=Amebic abscess of the liver. Diagnostic features. | journal=J Clin Gastroenterol | year= 1986 | volume= 8 | issue= 5 | pages= 550-4 | pmid=3782753 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3782753 }} </ref> | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
| Line 12: | Line 12: | ||
!Findings | !Findings | ||
|- | |- | ||
|'''Complete blood picture''' | |'''[[Complete Blood Count|Complete blood picture]]''' | ||
| | | | ||
*[[Hemoglobin]] <10g/dl | *[[Hemoglobin]] <10g/dl | ||
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*[[Neutrophilia]] | *[[Neutrophilia]] | ||
|- | |- | ||
|'''ESR and CRP''' | |'''[[Erythrocyte sedimentation rate|ESR]] and [[C-reactive protein|CRP]]''' | ||
|Elevated [[ESR]] and [[C-reactive protein]]<ref name="pmid14629771">{{cite journal| author=Blessmann J, Binh HD, Hung DM, Tannich E, Burchard G| title=Treatment of amoebic liver abscess with metronidazole alone or in combination with ultrasound-guided needle aspiration: a comparative, prospective and randomized study. | journal=Trop Med Int Health | year= 2003 | volume= 8 | issue= 11 | pages= 1030-4 | pmid=14629771 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14629771 }} </ref> | |Elevated [[ESR]] and [[C-reactive protein]]<ref name="pmid14629771">{{cite journal| author=Blessmann J, Binh HD, Hung DM, Tannich E, Burchard G| title=Treatment of amoebic liver abscess with metronidazole alone or in combination with ultrasound-guided needle aspiration: a comparative, prospective and randomized study. | journal=Trop Med Int Health | year= 2003 | volume= 8 | issue= 11 | pages= 1030-4 | pmid=14629771 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14629771 }} </ref> | ||
|- | |- | ||
|'''Liver function tests''' | |'''[[Liver function tests]]''' | ||
|[[Acute]] [[infection]]<ref name="pmid8265284">{{cite journal| author=Nazir Z, Moazam F| title=Amebic liver abscess in children. | journal=Pediatr Infect Dis J | year= 1993 | volume= 12 | issue= 11 | pages= 929-32 | pmid=8265284 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8265284 }} </ref><ref name="pmid3782753">{{cite journal| author=Thompson JE, Glasser AJ| title=Amebic abscess of the liver. Diagnostic features. | journal=J Clin Gastroenterol | year= 1986 | volume= 8 | issue= 5 | pages= 550-4 | pmid=3782753 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3782753 }} </ref> | |[[Acute]] [[infection]]<ref name="pmid8265284">{{cite journal| author=Nazir Z, Moazam F| title=Amebic liver abscess in children. | journal=Pediatr Infect Dis J | year= 1993 | volume= 12 | issue= 11 | pages= 929-32 | pmid=8265284 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8265284 }} </ref><ref name="pmid3782753">{{cite journal| author=Thompson JE, Glasser AJ| title=Amebic abscess of the liver. Diagnostic features. | journal=J Clin Gastroenterol | year= 1986 | volume= 8 | issue= 5 | pages= 550-4 | pmid=3782753 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3782753 }} </ref> | ||
* Elevated [[aspartate aminotransferase]] | * Elevated [[aspartate aminotransferase]] | ||
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[[Hyperbilirubinemia]] and [[hypoalbuminemia]] is more common in [[amoebic liver abscess]].<ref name="pmid15189463">{{cite journal| author=Lodhi S, Sarwari AR, Muzammil M, Salam A, Smego RA| title=Features distinguishing amoebic from pyogenic liver abscess: a review of 577 adult cases. | journal=Trop Med Int Health | year= 2004 | volume= 9 | issue= 6 | pages= 718-23 | pmid=15189463 | doi=10.1111/j.1365-3156.2004.01246.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15189463 }} </ref> | [[Hyperbilirubinemia]] and [[hypoalbuminemia]] is more common in [[amoebic liver abscess]].<ref name="pmid15189463">{{cite journal| author=Lodhi S, Sarwari AR, Muzammil M, Salam A, Smego RA| title=Features distinguishing amoebic from pyogenic liver abscess: a review of 577 adult cases. | journal=Trop Med Int Health | year= 2004 | volume= 9 | issue= 6 | pages= 718-23 | pmid=15189463 | doi=10.1111/j.1365-3156.2004.01246.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15189463 }} </ref> | ||
|- | |- | ||
|'''Stool examination''' | |'''[[Stool examination]]''' | ||
|Microscopic stool examination for cysts | |Microscopic stool examination for [[cysts]] | ||
* Microscopic stool examination for [[cysts]] is of little value due to [[infection]] with non-pathogenic [[strain]] of ''[[Entamoeba|E dispar]]''<ref name="pmid7803646">{{cite journal| author=Johnson JL, Baird JS, Hulbert TV, Opas LM| title=Amebic liver abscess in infancy: case report and review. | journal=Clin Infect Dis | year= 1994 | volume= 19 | issue= 4 | pages= 765-7 | pmid=7803646 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7803646 }} </ref> | * Microscopic stool examination for [[cysts]] is of little value due to [[infection]] with non-pathogenic [[strain]] of ''[[Entamoeba|E dispar]]''<ref name="pmid7803646">{{cite journal| author=Johnson JL, Baird JS, Hulbert TV, Opas LM| title=Amebic liver abscess in infancy: case report and review. | journal=Clin Infect Dis | year= 1994 | volume= 19 | issue= 4 | pages= 765-7 | pmid=7803646 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7803646 }} </ref> | ||
* If positive it suggests the diagnosis of [[amoebiasis]]. | * If positive it suggests the diagnosis of [[amoebiasis]]. | ||
* [[Cysts]] must be differentiated from ''[[Entamoeba|Entamoeba hartmanni]]'', ''[[Endolimax nana]]'', and ''[[Entamoeba|Entamoeba coli]]''. | * [[Cysts]] must be differentiated from ''[[Entamoeba|Entamoeba hartmanni]]'', ''[[Endolimax|Endolimax nana]]'', and ''[[Entamoeba|Entamoeba coli]]''. | ||
Examination for [[trophozoites]] | Examination for [[trophozoites]] | ||
*As the [[trophozoites]] are very sensitive and may be excreted intermittently, at least three fresh specimens are taken. | *As the [[trophozoites]] are very sensitive and may be excreted intermittently, at least three fresh specimens are taken. | ||
*A combination of iodine-stained concentrates, trichome-stained preparations, and wet mount are used. | *A combination of iodine-stained concentrates, [[trichome]]-stained preparations, and wet mount are used. | ||
*[[Trophozoites]] must be differentiated with [[neutrophils]]. | *[[Trophozoites]] must be differentiated with [[neutrophils]]. | ||
Findings suggestive of amoebic colitis include: | Findings suggestive of [[amoebic colitis]] include: | ||
* | * Charcot-leyden crystal protein | ||
* Positive test for [[heme]] | * Positive test for [[heme]] | ||
* A paucity of [[neutrophils]] | * A paucity of [[neutrophils]] | ||
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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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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
Laboratory tests consistent with diagnosis of amoebic liver abscess include complete blood count, ESR, C-reactive protein, liver function tests, and stool examination.[1][2][3][4]
Laboratory Findings
Laboratory tests consistent with diagnosis of amoebic liver abscess include:[1]
| Lab Test | Findings |
|---|---|
| Complete blood picture |
|
| ESR and CRP | Elevated ESR and C-reactive protein[2] |
| Liver function tests | Acute infection[3][4]
Hyperbilirubinemia and hypoalbuminemia is more common in amoebic liver abscess.[5] |
| Stool examination | Microscopic stool examination for cysts
Examination for trophozoites
Findings suggestive of amoebic colitis include:
|
References
- ↑ 1.0 1.1 Tanyuksel M, Petri WA (2003). "Laboratory diagnosis of amebiasis". Clin Microbiol Rev. 16 (4): 713–29. PMC 207118. PMID 14557296.
- ↑ 2.0 2.1 Blessmann J, Binh HD, Hung DM, Tannich E, Burchard G (2003). "Treatment of amoebic liver abscess with metronidazole alone or in combination with ultrasound-guided needle aspiration: a comparative, prospective and randomized study". Trop Med Int Health. 8 (11): 1030–4. PMID 14629771.
- ↑ 3.0 3.1 Nazir Z, Moazam F (1993). "Amebic liver abscess in children". Pediatr Infect Dis J. 12 (11): 929–32. PMID 8265284.
- ↑ 4.0 4.1 Thompson JE, Glasser AJ (1986). "Amebic abscess of the liver. Diagnostic features". J Clin Gastroenterol. 8 (5): 550–4. PMID 3782753.
- ↑ 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.
- ↑ Johnson JL, Baird JS, Hulbert TV, Opas LM (1994). "Amebic liver abscess in infancy: case report and review". Clin Infect Dis. 19 (4): 765–7. PMID 7803646.