Amoebic liver abscess physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]

Common physical examination findings associated with amoebic liver abscess may include sweating and ill appearing patient with weight loss, fever with chills, tachycardia, yellowish discoloration of skin (jaundice), icteric sclera, reduced breath sounds or crepitations at right lung base may be heard, chest tenderness on palpation and audible pericardial friction rub. Hepatomegaly with point tenderness over the liver, in the intercostal spaces, or below the ribs is a typical finding Epigastric mass if left lobe is involved. Abdominal guarding or rebound tenderness, dullness on percussion, abdominal distension and absent bowel sounds are other findings.^[1][2][3]

Common physical examination findings associated with amoebic liver abscess may include:^{[1][2][3][4][5]}

Appearance of patient

Patients with amoebic liver abscess are sweating and ill appearing. Appears thin due to weight loss in later stages of disease.

Vital signs

• High grade fever with chills
• Tachycardia

Skin

Yellowish discoloration of skin (jaundice)

HEENT

Icteric sclera

Lungs

Reduced breath sounds or crepitations at right lung base may be heard

Heart

• Chest tenderness on palpation
• Audible pericardial friction rub (sign associated with high mortality)
• S1 and S2 are normal

Abdomen

• Hepatomegaly with point tenderness over the liver, in the intercostal spaces, or below the ribs is a typical finding.^[4][5]
• Epigastric mass if left lobe is involved
• Abdominal guarding or rebound tenderness
• Due to dullness on percussion, the movement on right side of the chest and abdomen is restricted
• Abdominal distension in advanced cases
• Absent bowel sounds

Extremities

Bilateral pedal edema in advanced liver disease