A prospective study of one hundred cases of Amoebic liver abscess in a secondary care hospital of Delhi

Background: Amoebic liver abscess (ALA), which is caused by Entamoeba histolytica a protozoa is common and serious extra-intestinal manifestation of amoebiasis. ALA is prevalent in areas of poor sanitation and hygiene. It has varied clinical presentations and complications. This study highlights the recent clinical trends of ALA. Material and Methods: This study was a hospital based prospective observational study. All patients admitted from March to December 2011 with the diagnosis of ALA were included. Demographic and clinical history was recorded and the systematic examination was done to understand disease pattern. Clinical diagnosis was supported and confirmed by ultrasound abdomen and positive amoebic serology. The outcome of the patient was recorded at discharge. Data was analysed using SPSS 17. Results: Out of total 100 ALA Patients, 72% were from urban slums, 88% were uneducated and belonged to low socioeconomic status. 76% were alcoholic, 52% patients were in age group of 21–40 yrs with male preponderance (89%). Commonest presenting symptom was pain in right hypochondrium (94%)while jaundice was noticed in only 4%. Mean duration of symptoms before hospitalization was 10 days. Personal & family history was not contributory. Hepatomeagly was present in 52%. Mean TLC – 13694, Bilirubin – 1.27mg%. Serum Alkaline Phosphatase – 698 IU. X ray showed raised right diaphragm in 50% cases. On USG Examination 7% located in left lobe of liver and 84% were more than 5 cm in size. Multiple abscesses in 21%. Amoebic Serology was positive in all patients. Mean duration of hospitalization was 7 days. Management was done with metronidazole, antibiotics and/or percutaneous aspiration. Rupture occurred in 10%. One patient died of DIC. Conclusion: ALA is a medically treatable common infection prevalent in developing countries due to lack of sanitation and hygiene .Health education and adequate sanitation are imperative in preventing amoebic infections.