AMEBIC LIVER ABSCESS - 04/09/11

Doi : 10.1016/S0891-5520(05)70121-5

Molly A. Hughes, MD, PhD ^{^{*
Division of Infectious Diseases, Department of Medicine, University of Virginia Health Sciences Center, Charlottesville, Virginia}}, William A. Petri, MD, PhD ^{^{*
Division of Infectious Diseases, Department of Medicine, University of Virginia Health Sciences Center, Charlottesville, Virginia}}

Resumen

Amebiasis is a widespread parasitic disease caused by the protozoan Entamoeba histolytica. Amebiasis most commonly results in asymptomatic colonization of the gastrointestinal tract, but some patients may develop intestinal invasive disease with ulcerative and inflammatory lesions of the colon.^{4 Ahmed M., McAdam K.P.W.J., Sturm A.W. , y al. Systemic manifestations of invasive amebiasis Clin Infect Dis 1992 ; 15 : 974-982 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 42 Kimura K., Stoopen M., Reeder M.M. , y al. Amebiasis: Modern diagnostic imaging with pathological and clinical correlation Semin Roentgenol 1997 ; 32 : 250-275 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} Amebic liver abscess (ALA) is the most common extraintestinal manifestation of E. histolytica infection. Amebic liver abscess is marked by a significant male preponderance and is a disease seen most commonly in patients who reside in or have emigrated from an endemic area or have a recent travel history to an endemic area. Patients typically present with acute or chronic abdominal pain and associated constitutional symptoms, but rarely have concurrent dysentery or bloody stools.^{29 Greenstein A.J., Barth J., Dicker A. , y al. Amebic liver abscess: A study of 11 cases compared with a series of 38 patients with pyogenic abscess Am J Gastroenterol 1985 ; 80 : 472-478

Haga clic aquí para ir a la sección de Referencias, 41 Katzenstein D., Rickerson V., Braude A. New concepts of amebic liver abscess derived from hepatic imaging, serodiagnosis, and hepatic enzymes in 67 consecutive cases in San Diego Medicine 1982 ; 61 : 237-246

Haga clic aquí para ir a la sección de Referencias, 58 Petri W.A., Singh U. Diagnosis and management of amebiasis Clin Infect Dis 1999 ; 29 : 1117-1125 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} Stool examination and stool antigen detection tests are usually unhelpful because most patients with ALA do not have detectable parasites in their stool.^{58 Petri W.A., Singh U. Diagnosis and management of amebiasis Clin Infect Dis 1999 ; 29 : 1117-1125 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} Serologic testing with enzyme immunoassays (EIA) specific for E. histolytica circulating antibodies may aid in the diagnosis of ALA.^{32 Haque R., Ali I.M., Petri W.A. Prevalence and immune response to Entamoeba histolytica infection in preschool children in Bangladesh Am J Trop Med Hyg 1999 ; 60 : 1031-1034

Haga clic aquí para ir a la sección de Referencias} In most cases, medical management alone is sufficient to treat uncomplicated cases. Metronidazole remains the drug of choice for treatment of ALA followed by a luminal agent to eradicate the asymptomatic carrier state.^{24 Freeman C.D., Klutman N.E., Lamp K.C. Metronidazole: A therapeutic review and update Drugs 1997 ; 54 : 679-708 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 36 Irusen M.F., Jackson T.F.H.G., Simjee A.E. Asymptomatic intestinal colonization by pathogenic Entamoeba histolytica in amebic liver abscess: Prevalence, response to therapy, and pathogenic potential J Infect Dis 1992 ; 14 : 889-893

Haga clic aquí para ir a la sección de Referencias}

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Esquema

PATHOGENESIS

EPIDEMIOLOGY

CLINICAL DISEASE

Clinical Signs and Symptoms

Laboratory Features

Differential Diagnosis

Prognostic Factors

DIAGNOSTIC EVALUATION

History and Physical Examination

Serologic Tests

Radiologic Evaluation

TREATMENT

Drug Therapy

Aspiration of Liver Abscess

COMPLICATIONS OF AMEBIC LIVER ABSCESS

LONG-TERM OUTCOME

PREVENTION

Address reprint requests to Molly A. Hughes, MD, PhD, University of Virginia Health Sciences Center, Division of Infectious Diseases, MR4 Bldg., Box 2115, 300 Park Place, Charlottesville, VA 22908, e-mail: mah3x@virginia.edu
This work was supported by the National Institutes of Health, grant no. AI-43596.