Amoebic liver abscess overview: Difference between revisions
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==Natural history, Complications And Prognosis== | ==Natural history, Complications And Prognosis== | ||
If left untreated, [[amoebic liver abscess]] may disseminate to other organs leading to death.<ref name="pmid25917589">{{cite journal| author=Kurt Ö, Aktaş N, Çalışkan C, Karatuna O, Aygün H, Akyar I| title=[Amoebic liver abscess in a patient initially diagnosed with pneumonia: case report and discussion of relevant literature]. | journal=Turkiye Parazitol Derg | year= 2015 | volume= 39 | issue= 1 | pages= 70-4 | pmid=25917589 | doi=10.5152/tpd.2015.3608 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25917589 }} </ref>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]], [[superinfection|bacterial superinfection]], cutaneous [[fistula|fistulization]] of chest and abdominal wall, inferior venacava obstruction, [[hemobilia]] / thoracobilia, internal [[fistula|fistulization]], [[systemic inflammatory response syndrome]], [[Venous]] and [[artery|arterial]] [[thrombus|thrombosis]].<ref name="pmid7939926">{{cite journal| author=Meng XY, Wu JX| title=Perforated amebic liver abscess: clinical analysis of 110 cases. | journal=South Med J | year= 1994 | volume= 87 | issue= 10 | pages= 985-90 | pmid=7939926 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7939926 }} </ref><ref name="pmid18203038">{{cite journal| author=Peres LC, Saggioro FP, Dias LB, Alves VA, Brasil RA, Luiz VE et al.| title=Infectious diseases in paediatric pathology: experience from a developing country. | journal=Pathology | year= 2008 | volume= 40 | issue= 2 | pages= 161-75 | pmid=18203038 | doi=10.1080/00313020701816357 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18203038 }} </ref><ref name="pmid12959680">{{cite journal| author=Salles JM, Moraes LA, Salles MC| title=Hepatic amebiasis. | journal=Braz J Infect Dis | year= 2003 | volume= 7 | issue= 2 | pages= 96-110 | pmid=12959680 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12959680 }} </ref><ref name="pmid5014518">{{cite journal| author=Archampong EQ| title=Peritonitis from amoebic liver abscess. | journal=Br J Surg | year= 1972 | volume= 59 | issue= 3 | pages= 179-81 | pmid=5014518 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5014518 }} </ref><ref name="pmid2702459">{{cite journal| author=Sarda AK, Bal S, Sharma AK, Kapur MM| title=Intraperitoneal rupture of amoebic liver abscess. | journal=Br J Surg | year= 1989 | volume= 76 | issue= 2 | pages= 202-3 | pmid=2702459 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2702459 }} </ref><ref name="pmid1235314">{{cite journal| author=Ganesan TK, Kandaswamy S| title=Amebic pericarditis. | journal=Chest | year= 1975 | volume= 67 | issue= 1 | pages= 112-3 | pmid=1235314 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1235314 }} </ref><ref name="pmid7226956">{{cite journal| author=Ibarra-Pérez C| title=Thoracic complications of amebic abscess of the liver: report of 501 cases. | journal=Chest | year= 1981 | volume= 79 | issue= 6 | pages= 672-7 | pmid=7226956 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7226956 }} </ref><ref name="pmid12092041">{{cite journal| author=Shamsuzzaman SM, Hashiguchi Y| title=Thoracic amebiasis. | journal=Clin Chest Med | year= 2002 | volume= 23 | issue= 2 | pages= 479-92 | pmid=12092041 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12092041 }} </ref><ref name="pmid6699845">{{cite journal| author=Adeyemo AO, Aderounmu A| title=Intrathoracic complications of amoebic liver abscess. | journal=J R Soc Med | year= 1984 | volume= 77 | issue= 1 | pages= 17-21 | pmid=6699845 | doi= | pmc=1439560 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6699845 }} </ref><ref name="pmid9195675">{{cite journal| author=Lyche KD, Jensen WA| title=Pleuropulmonary amebiasis. | journal=Semin Respir Infect | year= 1997 | volume= 12 | issue= 2 | pages= 106-12 | pmid=9195675 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9195675 }} </ref><ref name="pmid2219891">{{cite journal| author=Lyche KD, Jensen WA, Kirsch CM, Yenokida GG, Maltz GS, Knauer CM| title=Pleuropulmonary manifestations of hepatic amebiasis. | journal=West J Med | year= 1990 | volume= 153 | issue= 3 | pages= 275-8 | pmid=2219891 | doi= | pmc=1002529 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2219891 }} </ref><ref name="pmid8678020">{{cite journal| author=Takhtani D, Kalagara S, Trehan MS, Chawla Y, Suri S| title=Intrapericardial rupture of amebic liver abscess managed with percutaneous drainage of liver abscess alone. | journal=Am J Gastroenterol | year= 1996 | volume= 91 | issue= 7 | pages= 1460-2 | pmid=8678020 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8678020 }} </ref>Prognosis is good with treatment. Patients who are treated have high chance of complete recovery or minor complications.<ref name="pmid8946991">{{cite journal| author=Sharma MP, Dasarathy S, Verma N, Saksena S, Shukla DK| title=Prognostic markers in amebic liver abscess: a prospective study. | journal=Am J Gastroenterol | year= 1996 | volume= 91 | issue= 12 | pages= 2584-8 | pmid=8946991 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8946991 }} </ref> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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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]
Synonyms and keywords: Hepatic amoebiasis; Extraintestinal amoebiasis; Abscess-amoebic liver
Overview
Amoebic liver abscess is caused by a protozoan Entamoeba histolytica. Is it an inflammatory space occupying lesion in liver.
Historical Perspective
Amoebiasis was first described as a deadly disease by Hippocrates. [1]. The first case of amoebiasis was documented in 1875.
Classification
Liver abscess may be classified into 3 types based on etiology into pyogenic, amoebic, and fungal liver abscess.[2]. Based on duration of symptoms, amoebic liver abscess is classified into acute and chronic.
Pathophysiology
Ameoebic liver abscess is caused by a protozoan Entamoeba histolytica. It is the most common extraintestinal manifestation of amoebiasis. The mode of transmission of Entamoeba histolytica include fecal-oral route (ingestion of food and water contaminated with feces containing cysts), sexual transmission via oral-rectal route in homosexuals, vector transmission via flies, cockroaches, and rodents.[3][4] Hepatocyte programmed cell death induced by Entamoeba histolytica causes amoebic liver abscess. The infection is transmitted to liver by portal venous system.[5]
Causes
Amoebic liver abscess is caused by a protozoan Entamoeba histolytica.
Differential Diagnosis
Epidemiology And Demographics
Amoebiasis is the second leading cause of death worldwide from parasitic disease.[6][7][8]500 million people are infected with Entamoeba histolytica every year. 50 million individuals develop liver abscess and colitis and results in death in 40,000-100,000 individuals annually. Of all cases of amoebiasis, 3% to 9% of patients reported to have amoebic liver abscess. It most commonly occurs in 20 to 45 years age.
Risk Factors
Common risk factors in the development of amoebic liver abscess include alcoholism, pregnancy, malnutrition, old age, immunosupression (including HIV), a recent travel to a tropical region, steroid use, hypoalbuminemia, chronic infection,tuberculosis, syphilis, splenectomy, malignancy, and homosexual.[9][10]
Screening
According to the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine screening for Entamoeba histolytica infection.
Natural history, Complications And Prognosis
If left untreated, amoebic liver abscess may disseminate to other organs leading to death.[11]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 venacava obstruction, hemobilia / thoracobilia, internal fistulization, systemic inflammatory response syndrome, Venous and arterial thrombosis.[12][13][14][15][16][17][18][19][20][21][22][23]Prognosis is good with treatment. Patients who are treated have high chance of complete recovery or minor complications.[24]
References
- ↑ Tanyuksel M, Petri WA (2003). "Laboratory diagnosis of amebiasis". Clin Microbiol Rev. 16 (4): 713–29. PMC 207118. PMID 14557296.
- ↑ Mavilia MG, Molina M, Wu GY (2016). "The Evolving Nature of Hepatic Abscess: A Review". J Clin Transl Hepatol. 4 (2): 158–68. doi:10.14218/JCTH.2016.00004. PMC 4913073. PMID 27350946.
- ↑ Fletcher SM, Stark D, Harkness J, Ellis J (2012). "Enteric protozoa in the developed world: a public health perspective". Clin Microbiol Rev. 25 (3): 420–49. doi:10.1128/CMR.05038-11. PMC 3416492. PMID 22763633.
- ↑ Stanley SL (2003). "Amoebiasis". Lancet. 361 (9362): 1025–34. doi:10.1016/S0140-6736(03)12830-9. PMID 12660071.
- ↑ Aikat BK, Bhusnurmath SR, Pal AK, Chhuttani PN, Datta DV (1979). "The pathology and pathogenesis of fatal hepatic amoebiasis--A study based on 79 autopsy cases". Trans. R. Soc. Trop. Med. Hyg. 73 (2): 188–92. PMID 473308.
- ↑ Leber, Amy L., and Susan Novak-Weekley. "Intestinal and urogenital amebae, flagellates, and ciliates." Manual of Clinical Microbiology, 10th Edition. American Society of Microbiology, 2011. 2149-2171.
- ↑ Baxt LA, Singh U (2008). "New insights into Entamoeba histolytica pathogenesis". Curr Opin Infect Dis. 21 (5): 489–94. doi:10.1097/QCO.0b013e32830ce75f. PMC 2688559. PMID 18725798.
- ↑ Haque R, Huston CD, Hughes M, Houpt E, Petri WA (2003). "Amebiasis". N Engl J Med. 348 (16): 1565–73. doi:10.1056/NEJMra022710. PMID 12700377.
- ↑ Krogstad DJ, Spencer HC, Healy GR, Gleason NN, Sexton DJ, Herron CA (1978). "Amebiasis: epidemiologic studies in the United States, 1971-1974". Ann Intern Med. 88 (1): 89–97. PMID 619763.
- ↑ Ximénez C, Morán P, Rojas L, Valadez A, Gómez A, Ramiro M; et al. (2011). "Novelties on amoebiasis: a neglected tropical disease". J Glob Infect Dis. 3 (2): 166–74. doi:10.4103/0974-777X.81695. PMC 3125031. PMID 21731305.
- ↑ 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.
- ↑ Meng XY, Wu JX (1994). "Perforated amebic liver abscess: clinical analysis of 110 cases". South Med J. 87 (10): 985–90. PMID 7939926.
- ↑ 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.
- ↑ Salles JM, Moraes LA, Salles MC (2003). "Hepatic amebiasis". Braz J Infect Dis. 7 (2): 96–110. PMID 12959680.
- ↑ Archampong EQ (1972). "Peritonitis from amoebic liver abscess". Br J Surg. 59 (3): 179–81. PMID 5014518.
- ↑ Sarda AK, Bal S, Sharma AK, Kapur MM (1989). "Intraperitoneal rupture of amoebic liver abscess". Br J Surg. 76 (2): 202–3. PMID 2702459.
- ↑ Ganesan TK, Kandaswamy S (1975). "Amebic pericarditis". Chest. 67 (1): 112–3. PMID 1235314.
- ↑ Ibarra-Pérez C (1981). "Thoracic complications of amebic abscess of the liver: report of 501 cases". Chest. 79 (6): 672–7. PMID 7226956.
- ↑ Shamsuzzaman SM, Hashiguchi Y (2002). "Thoracic amebiasis". Clin Chest Med. 23 (2): 479–92. PMID 12092041.
- ↑ Adeyemo AO, Aderounmu A (1984). "Intrathoracic complications of amoebic liver abscess". J R Soc Med. 77 (1): 17–21. PMC 1439560. PMID 6699845.
- ↑ Lyche KD, Jensen WA (1997). "Pleuropulmonary amebiasis". Semin Respir Infect. 12 (2): 106–12. PMID 9195675.
- ↑ 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.
- ↑ 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.
- ↑ 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.