What’s an amoebic liver abscess?

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An amoebic liver abscess is a pus-filled cyst that develops within the liver as a result of a severe parasitic infection. Abscesses develop when Entamoeba histolytica (E. histolytica), the parasite that causes dysentery, enters the walls of the digestive tract and migrates into the liver from the bloodstream. The infection can cause a number of bothersome symptoms, including high fever, chills, fatigue and upper abdominal pain. Treatment is usually aimed at killing the parasites with medication instead of repairing or removing the actual abscess, although surgical drainage of the cyst may be necessary if severe inflammation of the liver occurs.

E. histolytica is found worldwide and is transmitted from host to host through contact with infected feces. In most cases, infection is due to ingestion of contaminated food or water. A person of any age can develop an amoebic liver abscess, although middle-aged adults who live in or travel to poor, crowded regions are at the highest risk of infection. Males tend to get liver complications more often than females, though doctors aren’t sure why.

Once ingested, the E. histolytica parasites pass through the stomach and attach themselves to the walls of the small intestine. The parasites gradually break through the walls and escape into the bloodstream. When blood passes naturally through the liver, the parasites latch onto the liver lining and take advantage of the available proteins to mature, reproduce, and colonize. An amoebic liver abscess can develop in as little as a week after the initial infection.

Worsening abdominal pain and fever are the most common symptoms of an amoebic liver abscess. Many patients also experience gastrointestinal problems, such as diarrhea, vomiting, joint pain and fatigue. An untreated infection can spread from the liver to other vital organs, especially the lungs and heart. If the infection spreads, breathing difficulties, vision changes, fast heart rate, and mental confusion can become debilitating.

A doctor can usually diagnose an amoebic liver abscess by analyzing blood samples and imaging scans of the abdomen. Blood cultures that test positive for E. histolytica are clear signs that infection is present. Ultrasound and computed tomography may reveal well-defined, round lesions on or near the surface of the liver. After confirming a diagnosis and assessing the size of the abscess, specialists can determine the best course of treatment.

Most cases of E. histolytica infection in the digestive tract or liver can be cured with a ten-day course of medications called amebicides. Metronidazole is the most commonly prescribed amebicide for amoebic liver abscesses. Patients usually see symptom improvements within a few days and recover completely in less than a month. Occasionally, a doctor will decide to drain fluid from an abscess manually with a needle to provide more immediate relief from symptoms. Follow-up visits are important to ensure the infection doesn’t come back.

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