HEPATOBILIARY BACTERIAL, PROTOZOAN, AND HELMINTHIC INFECTIONS

Although liver abscess is often equated with Entamoeba histolytica inf ection, another etiology- most importantly pyogenic- is also relevant; management of the latter disease remains controversial and the outcom e is by no means always satisfactory. Other bacterial infections inclu de leptospirosis and sarcoidosis- a disease for which a causative agen t remains illusive. Although E. histolytica constitutes the most commo n protozoan infection involving the liver, Leishmania spp (increasingl y reported in association with HIV infection) should be considered amo ng the differential diagnoses. The liver is always involved in the lif e cycle of Plasmodium spp, but severe disease involving this organ is unusual, except in advanced, complicated disease. Two major heminthic infections involving the liver are Schistosoma spp and Echinococcus sp p; in the former, fibrosis can be arrested and even reversed by new ch emotherapeutic agents, and in the latter infection, management has als o advanced significantly. Worldwide, biliary helminths are dominated b y Fasciola hepatica. The ''hypereosinophilic syndrome without hepatic involvement'' remains enigmatic.