A 6 - year - old child is brought with high fever with rigors for 5 days with pain in right hypochonrium. On examination patient is anicteric and tenderness is noted in right upper quadrant. What is best investigation for this case?
- The patient is having pain in the right hypochondrium which suggests the involvement of the liver. - An abscess can be suspected as the patient is suffering from fever accompanied with rigors & pain and tenderness in the right upper outer quadrant - Abscess can be of two types: 1. Pyogenic liver abscess 2. Amoebic liver abscess Jaundice is common in patients of Pyogenic liver abscess which accounts for 20-25%. On the other hand, jaundice is rare in amoebic liver abscess On examination the patient is anicteric. So, the patient could be suffering from Amoebic liver abscess. In developing countries like India, Amoebic liver abscess is more common because of the feco-oral route and poor sanitation barrier Initial investigation for the diagnosis of amoebic liver abscess can be done by USG and CT-Scan. Investigation of choice or the best investigation for this patient is Serology i.e. ELISA which detects the anti-bodies formed by the parasite Entamoebahistolytica. The amoebic liver abscess can be treated by metronidazole empirically.
USG
Serology
SGOT/LFT
CECT
FMGE 2018