Amoebic liver abscess laboratory findings

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

Overview

Laboratory Findings

Laboratory tests consistent with diagnosis of amoebic liver abscess include:^[1]

Lab Test	Findings
Complete blood picture	Hemoglobin <10g/dl Leukocytosis Neutrophilia
ESR and CRP	Elevated ESR and C-reactive protein^[2]
Liver function tests	Acute infection^[3]^[4] Elevated aspartate aminotransferase Normal alkaline phosphatase Chronic infection Elevated aspartate aminotransferase Normal alkaline phosphatase Hyperbilirubinemia and hypoalbuminemia is more common in amoebic liver abscess.^[5]
Stool examination	Microscopic stool examination for cysts Microscopic stool examination for cysts is of little value due to infection with non-pathogenic strain of E dispar^[6] If positive it suggests the diagnosis of amoebiasis. Cysts must be differentiated from Entamoeba hartmanni, Endolimax nana, and Entamoeba coli. Examination for trophozoites As the trophozoites are very sensitive and may be excreted intermittently, at least three fresh specimens are taken. A combination of iodine-stained concentrates, trichome-stained preparations, and wet mount are used. Trophozoites must be differentiated with neutrophils. Findings suggestive of amoebic colitis include: Charcot-leyden crystal protein Positive test for heme A paucity of neutrophils

References

↑ ^1.0 ^1.1 Tanyuksel M, Petri WA (2003). “Laboratory diagnosis of amebiasis”. Clin Microbiol Rev. 16 (4): 713–29. PMC 207118. PMID 14557296.
↑ ^2.0 ^2.1 Blessmann J, Binh HD, Hung DM, Tannich E, Burchard G (2003). “Treatment of amoebic liver abscess with metronidazole alone or in combination with ultrasound-guided needle aspiration: a comparative, prospective and randomized study”. Trop Med Int Health. 8 (11): 1030–4. PMID 14629771.
↑ ^3.0 ^3.1 Nazir Z, Moazam F (1993). “Amebic liver abscess in children”. Pediatr Infect Dis J. 12 (11): 929–32. PMID 8265284.
↑ ^4.0 ^4.1 Thompson JE, Glasser AJ (1986). “Amebic abscess of the liver. Diagnostic features”. J Clin Gastroenterol. 8 (5): 550–4. PMID 3782753.
↑ Lodhi S, Sarwari AR, Muzammil M, Salam A, Smego RA (2004). “Features distinguishing amoebic from pyogenic liver abscess: a review of 577 adult cases”. Trop Med Int Health. 9 (6): 718–23. doi:10.1111/j.1365-3156.2004.01246.x. PMID 15189463.
↑ Johnson JL, Baird JS, Hulbert TV, Opas LM (1994). “Amebic liver abscess in infancy: case report and review”. Clin Infect Dis. 19 (4): 765–7. PMID 7803646.

Overview