Simultaneous occurrence of amoebic liver abscess and cecal ameboma

Rodrigues, Gabriel (2016) Simultaneous occurrence of amoebic liver abscess and cecal ameboma. Journal of Infection and Public Health, 9 (3). pp. 356-357. ISSN 1876-0341

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A 56-year-old male presented with severe pain in the right upper abdomen and fever associated with chills and rigors of 6 days’ duration. There was no jaundice, vomiting or abdominal symptoms and no history of recent travel. Upon examination, he was febrile (102.1 °C) and tachycardic (120/min) but not icteric. Abdominal examination revealed tender hepatomegaly and a vague, non-tender mass in the right iliac fossa. Blood tests showed neutrophilia. A CECT of the abdomen revealed a 15 × 10-cm abscess in the right upper lobe of the liver (Figure A) and a mass in the cecum (Figure B and Figure C). Amoebic serology was then performed and was positive. A clinical diagnosis of amoebic liver abscess and cecal ameboma was made, and the patient was started on metronidazole and diloxanide. CT-guided drainage and catheter placement of the abscess cavity was performed; a typical ‘anchovy sauce’ pus was drained, which was found to be positive for the trophozoites of Entamoeba histolytica. Stool examination was inconclusive. The patient symptomatically improved, and a colonoscopy was performed, which showed a friable cecal mass that was biopsied. Histopathology was consistent with an ameboma. Pus drainage diminished by the 8th day, and a USG revealed complete collapse of the abscess cavity, after which the catheter was removed. The patient completed drug therapy and a repeat USG of the abdomen; he is currently well with no recurrence.

Item Type: Article
Subjects: Medicine > KMC Manipal > Surgery
Depositing User: KMC Library
Date Deposited: 27 Mar 2017 04:04
Last Modified: 27 Mar 2017 04:04

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