The following statement(s) is/are true concerning the differential diagnosis between an amoebic and a pyogenic liver abscess.
- The clinical presentation is often clearly distinguishable
- A history of travel or origin from a high risk area might suggest an amebic liver abscess
- Routine liver chemistries frequently can distinguish pyogenic from amoebic liver abscess
- Serologic testing for the presence of antibody to entamoeba histolyctica is the only specific and sensitive way to confirm the diagnosis of amoebic liver abscess
- Distinguishing pyogenic from hepatic abscesses preoperatively is not important since surgical drainage is imperative for both
Medicine
b. A history of travel or origin from a high risk area might suggest an amebic liver abscess
d. Serologic testing for the presence of antibody to entamoeba histolyctica is the only specific and sensitive way to confirm the diagnosis of amoebic liver abscess
Distinguishing amoebic from pyogenic liver abscess can be a diagnostic challenge. It is of major importance, however, because effective medical therapy with metronidazole can obviate the need for either percutaneous or surgical drainage in most cases of amoebic abscess. The clinical presentation for both conditions with acute onset of fever, abdominal pain, and altered liver function tests are almost identical. Important features such as travel to or origin from a high risk area is particularly important for amebic liver abscess. Routine liver chemistries and radiographic studies can rarely distinguish between amoebic and pyogenic liver abscesses. Specific serologic tests for the presence of antibody to E. histolytica are specific and sensitive for amoebic hepatic abscess being positive in 95% of the cases, and therefore, are key in distinguishing the two infections.
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