Amoebic liver abscess history and symptoms

Specific areas of focus when obtaining a history from the patient include history of recent travel to or resident of endemic areas, time of onset (duration of symptoms <14 days), history of dysentery within the previous few months, fever and abdominal pain.^[1]Symptoms of amoebic liver abscess include moderate to severe abdominal pain, malaise, loss of appetite, sweating, weight loss, epigastric pain (Commonly seen in left lobe abscesses), fever (high fever with chills is suggestive of secondary bacterial infection), anorexia, pleuritic chest pain, Cough with or without expectoration and chest pain (may be due to abscess rupture into the pleural cavity), jaundice, confusion, abdominal distension, nausea and vomiting, diarrhea and constipation^{[2][3][4][5][6][7]}

Specific areas of focus when obtaining a history from the patient include history of amoebic liver abscess include:^[1]

• History of recent travel to or resident of endemic areas
• Time of onset (duration of symptoms <14 days)
• History of dysentery within the previous few months
• History of fever and abdominal pain

After exposure, 80% of infection patients develop symptoms with in few days to 4-5 weeks. Symptoms of amoebic liver abscess include:^{[3][4][5][6][7]}

Common symptoms

• Moderate to severe abdominal pain

• Localized to right upper quadrant radiated to right shoulder or diffuse
• Pain is intense, continuous or stabbing
• Pain aggravates with coughing, deep breathing, walking and while resting on right side

• Malaise (uneasiness, or ill feeling)
• Loss of appetite
• Nausea and vomiting
• Sweating
• Weight loss
• Epigastric pain (Commonly seen in left lobe abscesses)
• Fever (high fever with chills is suggestive of secondary bacterial infection)
• Anorexia
• Constipation

Symptoms associated with complications

• Pleuritic chest pain
• Cough with or without expectoration and chest pain (may be due to abscess rupture into the pleural cavity)

• Cough with odorless brown sputum indicates hepatopulmonary fistula^[2]

• Yellow discoloration of skin (Jaundice is seen in 1/3 of patients)
• Confusion (due to encephalopathy)
• Abdominal distension (due to ascites)
• Diarrhea