Lim Boon, Huat
(2009)
XVI Seminario sobre amibiasis 2009 y
embo workshop: amebiasis, molecular approaches in
an important but neglected disease.
Other.
Pusat Pengajian Sains Perubatan.
(Submitted)
Abstract
Amoebic liver abscess (ALA) is the most common extraintestinal
manifestation of amoebiasis in South East Asian countries and Mexico. Diagnosis is
based on clinical symptoms and signs; occurrence of space occupying lesion in liver
detected by imaging techniques, positive amoebic serology and clinical response to
antiamoebic therapy with metronidazole. The amoebic serological assay employed at
Hospital Universiti Sains Malaysia (HUSM), Kelantan is the commercial indirect
haemagglutination assay (IHA) kit which detects anti-Entamoeba histolytica antibodies
in serum samples. During the study period from January 2005 till June 2006, there
were 43 clinical or suspected cases of ALA. On admission, all patients presented with
fever. Thirty nine of them had abdominal pain; 9 had history of passing loose stools; 42
presented with hepatomegaly while 15 had jaundice; and 37 presented with
leucocytosis. Thirty three patients had liver abscesses in their right lobe, 6 with
abscesses in the left lobe and 4 had abscesses in both lobes of the liver. The IHA test
were positive (titer more than or equal to 1 :256) in 33 (76.7%) patients. Forty two of
the patients were treated with intravenous metronidazole 500 mg every 8 hours and
continued with oral metronidazole when the patients were discharged. In the
amoebiasis endemic setting in Kelantan, interpretation of IHA results can be
problematic due to the high background antibody levels Therefore, a simple, rapid,
noninvasive test with high sensitivity and specificity for laboratory diagnosis of ALA is
urgently needed.
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