| ID | 53 |
|---|---|
| Name | HEPATIC AMOEBIASIS |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | Investigations: 1. Blood picture: (a) mild to moderate anemia; (b) moderate leucocytosis 2. Stool (microscopic exam): stool may contain cysts of amoebia. 3. Liver function tests: slightly abnormal findings of liver function tests. 4. X-ray chest: an elevated right hemidiaphragm is frequently seen, if there is abscess formation. 5. Ultrasonography: hcpatobiliary system (confinnatory). 7. Aspirated pus from an amoebic abscess has the charac-teristic appearence |
| Management | |
| Introduction | Hepatic amoebiasis is the infection of liver by Entamoeba histolytica. It often occurs without a history of recent diarrhoea. But about 20% of patients may present with a history of recent diarrhoeal episodes. |
| History | |
| Etiology | |
| Clinical Features | Clinical features: Symptoms: 1. May be complaint of local discomfort only and malaise. 2. Latter, temperature and sweating. 3. Enlarged tender liver, and pain in the right shouldet 4. But symptoms may remain vague. Sings: 1. A moderate neutrophil leucocytosis. 2. A raised diaphragm (may be seen in the x-ray film). 3. Liver may be febrile & tender |
| Preventions | |
| Treatment | Treatment1: 1. Drugs of choice: Metronidazole 500mg 3 times daily orally for 10 days (an i.v metronidazole preparation may be given if requird- dosege as recommended, & change to oral medication as soon as possible). Or, Tinidazole 500mg 3 times daily for 5 days. Plus-Diloxanide furoate 500mg 3 times daily with meals for 10 days. Followed by- Chloroquine 500mg daily for 14 days. Alternative drugs: Inj. Dehydroemetine or Emetine hydrochloride 60mg (or Img/kg) i.m or subcutaneously daily for 8-10 days. Followed by- Chloroquine 500mg orally twice daily for 2 days & then 500mg orally daily for 19 days. Plus-Diloxanide furoate 500mg 3 times daily with meals for 10 days (to eliminate luminal cyst). 2. If the response to chemotherapy is not prompt, aspiration is also necessary (by a wide-bore needle). 3. If culture of pus indicates that there is secondary bacterial infection; treatment will be required with an appropriate antibiotic. 4. A course of metronidazole after aspiration. 5. Stool specimens are to be reexamined after 4 weeks |
| Complications | |
| Prognosis | |
| Types | |
| Classification | |
| Observation | |
| Pathology |
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