DIAGNOSIS OF AMEBIC INFECTION OF THE LIVER - REPORT OF 36 CASES

The classical clinical picture of amoebic infection of the liver consi sts of fever, right upper quadrant pain and hepatomegaly. In recent ye ars, the widespread availability of ultrasound and serology made an ea rly diagnosis possible, which could result in less prominent clinical pictures. Thirty six cases of liver amoebiasis diagnosed in Antwerp be tween 1985 and 1992, were reviewed. Three patients acquired their infe ction in Belgium. For the other patients, the average delay between ar rival in Belgium and the first symptoms was 5.64 months. The classical triad of clinical signs (fever, right upper quadrant pain and hepatom egaly), was observed in only 13.9% of the patients, whereas it was muc h more frequent in earlier studies (68-75%). The right lobe was the mo st frequently affected (94%). The colour of the liquid, obtained by pu ncture, was brown in 61% of patients In whom it was reported. Amoebic cysts were found in the stools of only one patient. Amoebic serology w as initially negative in only one patient, but became positive on seco nd testing. Chest X-rays were abnormal in 34% of the patients. All pat ients who develop unexplained fever during the year after a stay in tr opical countries should undergo an abdominal ultrasound examination an d serological testing for Entamoeba histolytica.