False‐Negative Serologies in Amebic Liver Abscess: Report of Two Cases

Otto, Marie-Pierre; Gérôme, P.; Rapp, C.; Pavic, Michel; Vitry, T.; Crevon, L.; Debourdeau, Philippe; Simon, Fabrice

doi:10.1111/jtm.12007

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…Due to long-term positivity following exposure, it is of less value in high endemicity settings where patients may have been previously exposed [6]. The test can also be falsely negative in case of acute presentations, patient's immune response, the type of serologic test or the pathogen strain [7]. The clinical presentation of both amoebic and PLA is indistinguishable.…”

Section: Introductionmentioning

confidence: 99%

Clinical Profile of Liver Abscess: A Hospital Based Prospective Study.

Pradhan

Amit

Singh

2020

IJMBS

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Objectives: Liver abscess (LA) is defined as collection of purulent material in liver parenchyma which can be due to bacterial, parasitic, fungal, or mixed infection. The liver abscess is mainly classified into amoebic and pyogenic. This present study was to evaluate the aetiology, clinical profile, management and prognosis of liver abscess patients. Methods: A detail history, clinical examinations and relevant investigations were performed to all liver abscess patients. Investigations was performed like as routine blood investigations, chest x-ray, PA view, X-ray abdomen, AP view, ultrasound abdomen, CT scan abdomen (if needed). Culture and sensitivity of the aspirate was performed. Results: Data was analysed by using simple statistical methods with the help of MS-Office software. Conclusions: Liver abscess was commonly seen in elderly age groups. Male was more preponderance than females. Amoebic liver abscess was commonly found. Amoebic liver abscess was commonly seen in alcoholic patients. Abdominal pain, fever and abdominal distension were common clinical symptoms. Tenderness on right hypochondrial, intercostal region and hepatomegaly were the common clinical sign of liver abscess. Abscess was mostly seen in right lobe than left lobe. Most of the patients were managed by percutaneous single aspiration. If aspiration was failed, percutaneous catheter drainage was the choice for management of liver abscess. Hence, A very prompt recognition is important in instituting effective management and achieving good outcomes. Because of the nonspecific symptoms and laboratory findings, the presence of predisposing factors can be helpful in increasing the level of diagnostic suspicion. The key to successful outcome in the management of liver abscess is early diagnosis and appropriate therapy. Keywords: Liver abscess, age group, amoebic liver abscess, pyogenic liver abscess, alcoholic, management of liver abscess

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Section: Introductionmentioning

confidence: 99%

Clinical Profile of Liver Abscess: A Hospital Based Prospective Study.

Pradhan

Amit

Singh

2020

IJMBS

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“…Serology is considered a reliable test with a very high sensitivity and specificity, but in endemic areas, this test suffers from specificity issues as the chances of false positivity are there owing to past exposure to the parasite. [ 27 ]…”

Section: Discussionmentioning

confidence: 99%

Clinical and laboratory profile of patients with amoebic liver abscess

et al. 2022

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Context: Amebic liver abscess (ALA) occurs in 3%–9% of the amebiasis cases, with complications seen in 20%–40% of the cases and 2%–18% mortality rate. Successful treatment thus requires the accurate identification of these cases. Aims and Objectives: We aimed to assess the seropositivity and profile of ALA patients in western Rajasthan. Materials and Methods: This retrospective study was conducted at a tertiary care center in western Rajasthan from November 2017 to May 2019. Serological diagnosis of ALA was done by detecting immunoglobulin G (IgG) antibodies in the serum of the patients by ELISA. The derangements in laboratory profile (hematological and biochemical parameters) and ultrasonography findings were assessed from the hospital records. Statistical analysis was performed using Mann–Whitney U-test. Results: Among the total cases ( n = 34), 20 were diagnosed as ALA. Twenty-one (61.8%) were positive for anti-amebic IgG antibodies. Among ALA patients, 14 (70%) were >40 years old and only 6 (30%) patients were of age ≤40 years. Male: female ratio was 5.7:1, and ultrasonography records of 15 ALA patients revealed the presence of hepatomegaly ( n = 7, 46.7%), pleural effusion ( n = 3, 20%), lung collapse ( n = 2, 13.3%), and vascular involvement ( n = 1, 6.7%). The right lobe of the liver was involved in majority of the patients ( n = 12, 80%). Total white blood cell count ( P < 0.001), absolute neutrophil count ( P = 0.001), total serum bilirubin ( P = 0.019), and serum alkaline phosphatase ( P = 0.018) were significantly elevated in ALA patients. Conclusions: Seroprevalence shows that ALA still remains the dominant etiology in liver abscess patients in this region. There are significant derangements in the laboratory profile that require a larger study for corroboration.

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“…Moreover, it is impossible to differentiate the pathogenic species ( E. histolytica ) from non-pathogenic species ( E. dispar or E. moshkovskii ), except if phagocytized red blood cells are present within the trophozoite, thus confirming the diagnosis of E. histolytica . Diagnosis of ALA is usually based on amebiasis serology even though negative serology cases have been described [17, 20]. The combination of serological tests and PCR on a puncture of the liver abscess offers the best diagnostic approach.…”

Section: Discussionmentioning

confidence: 99%

First case of amebic liver abscess 22 years after the first occurrence

et al. 2015

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A 72-year-old man consulted in November 2012 for abdominal pain in the right upper quadrant. The patient had a history of suspected hepatic amebiasis treated in Senegal in 1985 and has not traveled to endemic areas since 1990. Abdominal CT scan revealed a liver abscess. At first, no parasitological tests were performed and the patient was treated with broad-spectrum antibiotics. Only after failure of this therapy, serology and PCR performed after liver abscess puncture established the diagnosis of hepatic amebiasis. The patient was treated with metronidazole and tiliquinol-tilbroquinol. Amebic liver abscess is the most frequent extra-intestinal manifestation. Hepatic amebiasis 22 years after the last visit to an endemic area is exceptional and raises questions on the mechanisms of latency and recurrence of these intestinal protozoan parasites.

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False‐Negative Serologies in Amebic Liver Abscess: Report of Two Cases

Cited by 5 publications

References 10 publications

Clinical Profile of Liver Abscess: A Hospital Based Prospective Study.

Clinical Profile of Liver Abscess: A Hospital Based Prospective Study.

Clinical and laboratory profile of patients with amoebic liver abscess

First case of amebic liver abscess 22 years after the first occurrence

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