All are true about amoebic liver abscess, except -
Ans. is 'b' i.e., More common in left lobe Amoebic Liver abscesso Caused by Entamoeba histolytica whose cysts are acquired through the feco-oral route and their trophozoites reach the liver through portal venous system,o Like pyogenic abscess they are also common in rt. lobe of liver.Clinical featuresy The typical clinical picture is of a patient 20-40yrs of age who has travelled to an endemic area, presents with fever, chills, anorexia, rt. upper quadrant pain.Although liver abscess results from an obligatory colonic infection, a recent history of diarrhoea is uncommon. Jaundice is rare (c.f. in pyogenic abscess jaundice is seen in -25% of pts.).o Liver function tests may show mild abnormalities, hyperbilirubinemia is uncommon.o CT > LVS are the mainstay of investigation.o Diagnosis is confirmed by serological tests (enzyme immune assay) for antiamoebic antibodies,o Cultures of amoebic abscess are usually negative.Treatmento Metronidazole is the mainstay of ft and is curative in over 90% of patients.(other nitroimidazoles i.e. secnidazole, tinidazole, are also effective)o Therapeutic needle aspiration is avoided. Done only whenPt. fails to respond to metronidazoleHigh risk of ruptureAbscess secondarily infected with pyogenic organism.Complicationso May occur uncommonly; these are :Rupture into the peritoneum, pleural cavity or pericardium.
More common in 20-40 years
More common in left lobe
Metronidazole is mainstay of treatment
Multiple abscess can not be drained by aspiration
Hepatic Tumors, Cysts, and Abscesses