HEPATIC AMEBIASIS - AN UNUSUAL CLINICAL PRESENTATION

BACKGROUND: Painful liver enlargement with fever are common signs of h epatic ambiasis. Exceptionally, atypical signs may also occur includin g symptoms suggesting renal sepsis. CASE REPORT: An 18-year-old woman from the New Caledonia was hospitalized in metropolitan France for sus pected right-sided acute pyelonephritis. Urinalysis was normal and the kidney ultrasound suggested the need for an abdominal CT-scan which e videnced a voluminous 10-cm abscess pus. Serology for amebia was posit ive, confirming the diagnosis of hepatic amebic abscess. Outcome was r apidly favorable with intravenous anti-parasite treatment amebic absce ss. Outcome was rapidly favorable with intravenous anti-parasite treat ment and percutaneous drainage. DISCUSSION: Atypical signs of hepatic ambiasis may mislead diagnosis. The absence of a fetid odor at punctur e helps guide diagnosis, confirmed by serology. Percutaneous drainage can hbe proposed for voluminous abscesses or it the risk of extrahepat ic complications is eminent. (C) 1998, Masson, Paris.