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Amebic liver abscess

Contents of this page:

Illustrations

Liver cell death
Liver cell death

Alternative Names    Return to top

Hepatic amebiasis; Extraintestinal amebiasis; Abscess - amebic liver

Definition    Return to top

Amebic liver abscess is a collection of pus in the liver brought on by an intestinal parasite.

Causes    Return to top

Amebic liver abscess is caused by Entamoeba histolytica, the same organism that causes amebiasis, an intestinal infection also called amebic dysentery. The organism is carried by the blood from the intestines to the liver.

The disease spreads through ingestion of amebic cysts in food or water contaminated with feces (sometimes due to use of human waste as fertilizer), and through person-to-person contact.

The infection occurs worldwide, but is most common in tropical areas where crowded living conditions and poor sanitation exist. Africa, Latin America, Southeast Asia, and India have significant health problems associated with this disease.

Risk factors for amebic liver abscess include:

Symptoms    Return to top

There may or may not be symptoms of intestinal infection. Symptoms may include:

Exams and Tests    Return to top

Tests that may be done include:

Treatment    Return to top

An antibiotic medicine called metronidazole (Flagyl) is the usual treatment for liver abscess. A medication such as iodoquinol must also be taken to get rid of all the amebas in the intestine, to prevent the disease from coming back. This can usually be delayed until after the abscess has been treated.

In rare cases, the abscess may need to be drained to help relieve some of the abdominal pain.

Outlook (Prognosis)    Return to top

Without treatment, the abscess may rupture and spread into other organs, leading to death. Persons who receive treatment have a very high chance of a complete cure or having only minor complications.

Possible Complications    Return to top

The abscess may rupture into the abdominal cavity, the lining of the lungs, the lungs, or the sac around the heart. The infection can also spread to the brain.

When to Contact a Medical Professional    Return to top

Call your health care provider if you develop symptoms of this disease, especially if you've recently traveled to an area where the disease is known to occur.

Prevention    Return to top

When traveling in tropical countries where poor sanitation exists, drink purified water and do not eat uncooked vegetables or unpeeled fruit.

References    Return to top

Neuschwander-Tetri BA. Bacterial, parasitic, fungal, and granulomatous liver disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. 2007: chap 155.

Update Date: 5/30/2009

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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