Amoebic liver abscess other diagnostic studies

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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

Needle aspiration

Needle aspiration is used to differentiate between amoebic and pyogenic liver abscess
The ultrasound and CT are used to guide percutaneous aspiration and drainage.
The aspirated fluid is odorless unless secondarily infected
The pathognomonic of the aspirate is the reddish-brown anchovy paste appearance, which indicates that the abscess has been present for weeks.
The trophozoites are present only in the wall of the abscess. Rest of abscess is composed of lysed leukocytes.

Laboratory Method	Findings
Microscopy	Microscopic techniques include 1. Wet preparation 2. Concentration 3. Permanently stained smears Wet (Saline) preparation Very insensitive method (<10%) Procedure The sample is a fresh specimen that should be examined within 1 hr of collection The test is positive when RBCs in trophozoites are detected It is not used in patients without acute dysentery as trophozoites will not contain RBCs Concentration Technique It is helpful in detecting cysts in the stool sample in asymptomatic carriers Permanently stained smears This is an important method for identification and recovery of Entamoeba species
Culture Methods
Isoenzyme analysis
Antibody Detection Tests
Antigen Detection Tests
Immunochromatographic Assays

DNA-Based Diagnostic Tests