Amoebic liver abscess physical examination

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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

Physical Examination

Common physical examination findings associated with amoebic liver abscess may include:[1][2][3]

Appearance of patient

Patients with amoebic liver abscess are sweating and ill appearing. Appears thin due to weight loss in later stages of disease.

Vital signs

  • High grade fever with chills
  • Tachycardia

Skin

Yellowish discoloration of skin (jaundice)

HEENT

Icteric sclera

Lungs

Reduced breath sounds or crepitations at right lung base may be heard

Heart

  • Chest tenderness on palpation
  • Audible pericardial friction rub (sign associated with high mortality)
  • S1 and S2 are normal

Abdomen

  • Hepatomegaly with point tenderness over the liver, in the intercostal spaces, or below the ribs is a typical finding.[4][5]
  • Epigastric mass if left lobe is involved
  • Abdominal guarding or rebound tenderness
  • Due to dullness on percussion, the mvement on right side of the chest and abdomen is restricted
  • Abdominal distension in advanced cases
  • Absent bowel sounds

Extremities

Bilateral pedal edema in advanced liver disease

References

  1. https://medlineplus.gov/ency/article/000211.htm Accessed on february 8, 2017
  2. Hoffner RJ, Kilaghbian T, Esekogwu VI, Henderson SO (1999). "Common presentations of amebic liver abscess". Ann Emerg Med. 34 (3): 351–5. PMID 10459092.
  3. Wiwanitkit V (2002). "A note on clinical presentations of amebic liver abscess: an overview from 62 Thai patients". BMC Fam Pract. 3: 13. PMC 122079. PMID 12149132.
  4. Adams EB, MacLeod IN (1977). "Invasive amebiasis. II. Amebic liver abscess and its complications". Medicine (Baltimore). 56 (4): 325–34. PMID 875719.
  5. Katzenstein D, Rickerson V, Braude A (1982). "New concepts of amebic liver abscess derived from hepatic imaging, serodiagnosis, and hepatic enzymes in 67 consecutive cases in San Diego". Medicine (Baltimore). 61 (4): 237–46. PMID 6806561.