Amoebic liver abscess pathophysiology
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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
Ameoebic liver abscess is caused by a protozoan Entamoeba histolytica. It is the most common extraintestinal manifestation of amoebiasis.
Pathophysiology
- Amoebic liver abscess is the most common extraintestinal manifestation of amoebiasis.
- There are two genetically different species of entamoeba.[1] They are
- Mode of transmission of Entamoeba histolytica include
- Fecal-oral route (ingestion of food and water contaminated with feces containing cysts)
- Hepatocyte programmed cell death induced by Entamoeba histolytica causes amoebic liver abscess.
- The infection is transmitted to liver by portal venous system.[2]
- Clinical syndromes associated with Entamoeba histolytica infection
| Entamoeba histolytica | |||||||||||||||||||||||||||||||||||||||||||||||
| Intestinal amoebiasis •Asymptomatic cyst passers •Acute amoebic colitis - Mucosal disease - Transmural disease - Ulcerative postdysentric colitis *Appendicitis *Amoeboma *Amoebic stricture | Extra intestinal amoebiasis *Amoebic Liver abscess *Perforation and peritonitis *Pleuropulmonary amoebiasis *Amoebic pericarditis *Cutaneous Amoebiasis | ||||||||||||||||||||||||||||||||||||||||||||||
Pathogenesis
- Solitary lesions (30%-70%) are more common amoebic liver abscesses and most commonly seen in right lobe of the liver.
| Variants of amoebic liver abscess | ||||
|---|---|---|---|---|
| Multiple liver abscesses | Left lobe abscess | Compression lesions | Extension of the abscess | |
| 15% of patients | 35% of patients | 7% of patients | ||
| Symptoms | Fever
Toxaemia Deep jaundice Encephalopathy |
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References
- ↑ Gonin P, Trudel L (2003). "Detection and differentiation of Entamoeba histolytica and Entamoeba dispar isolates in clinical samples by PCR and enzyme-linked immunosorbent assay". J Clin Microbiol. 41 (1): 237–41. PMC 149615. PMID 12517854.
- ↑ 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.