Recurrent amebic liver abscess

Singal, Dinesh; Mittal, Amit; Prakash, Anukalp

doi:10.1007/s12664-012-0210-4

Cited by 7 publications

(7 citation statements)

References 4 publications

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“…22 Recurrent ALA has been described to be more common with factors such as alcohol, corticosteroids, and immunosuppression. 18 This is in concordance with this study as majority (7/9) of the patients were chronic alcoholics. The duration between the first and second liver abscess varied from 28 to 60 weeks, having a mean duration of 41 ± 11.3 weeks.…”

Section: Discussionsupporting

confidence: 91%

“…Individual case reports are on record from India in the recent past where multiple relapses of ALA have been reported, despite metronidazole treatment. 18 A recurrence rate of 6.7% has been previously reported from Bangladesh in a similar 2-year follow-up study. 13 Among the other sporadic reports of recurrence, one study revealed the case of an individual developing three episodes of ALA in a period of 4 years in which the second episode of ALA was seen 18 months after the first one and the third appeared 12 months after the second one.…”

Section: Discussionsupporting

confidence: 53%

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Factors Associated with High Rates of Recurrence of Amebic Liver Abscess (ALA) in North India

Singh

Banerjee

Shukla

2021

The American Journal of Tropical Medicine and Hygiene

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Recurrence of amebic liver abscess (ALA), once considered unusual, is increasingly being reported, despite proper management. Realizing the endemicity of ALA in the study setup, this 2-year follow-up study was conducted to investigate the recurrent cases and study the associated factors. A total of 101 confirmed cases of ALA were followed up for a period of 2 years. Recurrent cases were studied for associated bacterial flora, presence of resistance genes (nim), level of matrix metalloproteinase 3 and MMP-9, and genotypes of Entamoeba histolytica and statistically compared with the nonrecurrent cases as controls. Recurrence rates of 8.9% (nine patients) were detected. The presence of Prevotella along with an increased level of MMP-9 in abscess fluid and large size of abscesses (11 × 10.8 cm) was found to be significantly associated with recurrence in ALA. Among the nine cases, the presence of nimE gene was detected in two (22.2%) patients. The genotyping of E. histolytica strains showed that in seven (77.7%) cases, the genotype of E. histolytica was the same in the primary and recurrent samples. This study reports a high rate of recurrence in the cases of ALA, hinting toward the gradual development of clinical resistance toward the commonly used drug. The presence of nim gene and Prevotella in abscess fluid along with increased MMP-9 levels and large abscess size could be important predictors of recurrent ALA.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 53%

Factors Associated with High Rates of Recurrence of Amebic Liver Abscess (ALA) in North India

Singh

Banerjee

Shukla

2021

The American Journal of Tropical Medicine and Hygiene

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“…Two similar cases were recently published. In 2012, Singal et al described a patient living in India (an endemic area) with multiple relapses despite treatment with metronidazole [24]. In the other article, the authors describe a patient living in France with a recurrent amebic abscess 10 years after the first occurrence [10].…”

Section: Discussionmentioning

confidence: 99%

“…Relapses of ALA are rare and have been estimated at 0.004% of the ALA patients per year. A long latent period may exist between the first episode of ALA and the relapse (up to 17 years in a case described by Shizuma et al, 2000) [10, 13, 19, 21, 23, 24]. …”

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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“…Recurrence of amebic liver abscess after appropriate treatment with the combination of a nitroimidazole derivate with a luminal agent is rare with only a few previous reports [ 2 – 4 ]. The majority of those recurrences could be explained by failure to administer an adequate luminal agent [ 5 – 8 ]. We report an extraordinary case of a Caucasian (Dutch) male patient, who developed amebic liver abscesses three times over a period of 16 years, despite adequate combination treatment on each occasion.…”

Section: Introductionmentioning

confidence: 99%

Recurrent amebic liver abscesses over a 16-year period: a case report

et al. 2016

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BackgroundAmebic liver abscess is a rare disease in high-income countries. Recurrence of amebic liver abscess is even rarer with only a few previous reports. Here we present a patient who developed three subsequent amebic liver abscesses over a sixteen-year period.Case presentationA Caucasian male developed recurrent amebic liver abscesses, when aged 23, 27 and 39 years. Only on the first occasion did this coincide with a recent visit to the tropics. The patient received adequate treatment during each episode. Possible explanations are persistent asymptomatic carrier state, cysts passage in his family, re-infection or chance.ConclusionWe describe the unusual case of a healthy male who developed recurrent amebic liver abscesses over a long period despite adequate treatment. Possible pathophysiological explanations are explored.

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Recurrent amebic liver abscess

Abstract: Recurrence of amebic liver abscess is uncommon. We report a 62-year-old man presenting with amebic liver abscess thrice in last 5 years.

Cited by 7 publications

References 4 publications

Factors Associated with High Rates of Recurrence of Amebic Liver Abscess (ALA) in North India

Factors Associated with High Rates of Recurrence of Amebic Liver Abscess (ALA) in North India

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

Recurrent amebic liver abscesses over a 16-year period: a case report

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