AMEBIC LIVER-ABSCESS IN CHILDREN

Although amebic liver abscess can be a cause of significant morbidity and mortality in all ages, there are few reports dealing with this ent ity in children. Twenty-four children with amebic liver abscess, ages ranging between 3 weeks and 14.5 years, were managed at the Aga Khan U niversity Hospital, Karachi, Pakistan, between November, 1987, and Oct ober, 1992. The most frequent presentation was high grade fever and ri ght upper quadrant pain, associated with tender hepatomegaly, leukocyt osis and an elevated erythrocyte sedimentation rate. The diagnosis was confirmed by elevated indirect hemagglutination titers and ultrasonog raphy of the liver. Unlike the experience in adult patients none of th e patients had concomitant jaundice, and significant derangement of li ver enzymes was unusual. The abscesses were likely to be solitary (22 of 24 patients). There were no deaths despite a mean delay of 15 days before presentation to our hospital. A high index of suspicion, early institution of metronidazole therapy and, aspiration of abscesses with potential to rupture are believed to have contributed to the better o utcome in these children when compared with results in previous report s.