Amoebic Liver Abscess with Hepatic Encephalopathy: A Case Report
Journal name: The Malaysian Journal of Medical Sciences
Original article title: An Unusual Case of Amoebic Liver Abscess Presenting with Hepatic Encephalopathy: A Case Report
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:
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Anil Kumar Sarda, Rakesh Mittal
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: An Unusual Case of Amoebic Liver Abscess Presenting with Hepatic Encephalopathy: A Case Report
Year: 2011
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
Amoebic liver abscess (ALA) is a prevalent extra-intestinal manifestation of Entamoeba histolytica infection, often presenting mild jaundice, which is considered unusual. Although jaundice typically indicates hepatocellular dysfunction or intrahepatic biliary obstruction in cases of ALA, its presence may correlate with increased mortality and complications such as hepatic encephalopathy and septicaemia. This case report highlights a 24-year-old male with a massive ALA who presented with jaundice, hepatic encephalopathy, and septicaemia, and discusses the successful management of this complex condition.
Uncommon Presentation of Jaundice and Hepatic Encephalopathy
The case presented delineates an atypical instance where a solitary large ALA caused both jaundice and hepatic encephalopathy, challenging the prevailing assumptions that jaundice in ALA is rare and primarily seen in patients with multiple abscesses. The patient was diagnosed through clinical examination, imaging studies, and serological testing. Management comprised anti-amoebic therapy and percutaneous drainage of the abscess, followed by the resolution of symptoms, thus illustrating the potential for effective treatment even in severe presentations. The patient's clinical trajectory emphasizes how a solitary larger abscess can lead to biliary obstruction and hepatic dysfunction, underscoring the importance of considering ALA in differential diagnoses of jaundiced patients.
Conclusion
This case raises critical insights into the complications associated with amoebic liver abscesses, specifically the rare yet severe manifestations of jaundice and hepatic encephalopathy. Despite the challenges posed by septicaemia and deteriorating liver function, the integration of medical therapy and procedural intervention led to a favorable clinical outcome. This report advocates for heightened awareness of ALA as a potential cause of jaundice and encephalopathy, thereby improving diagnosis and treatment, ultimately contributing to better patient management and reduced mortality rates in such complex cases.
FAQ section (important questions/answers):
What is an amoebic liver abscess and its symptoms?
Amoebic liver abscess (ALA) is a common extra-intestinal manifestation of Entamoeba histolytica infection. Symptoms may include high-grade fever, right upper abdominal pain, jaundice, and encephalopathy.
How can jaundice be related to amoebic liver abscess?
Jaundice in ALA may result from hepatocellular dysfunction or intrahepatic biliary obstruction caused by a large abscess compressing bile ducts, leading to bile stasis.
What treatment options are available for amoebic liver abscess?
Treatment options include anti-amoebic therapy and catheter drainage of the abscess. Surgical interventions may be considered in severe cases or for complications.
What does the recovery process look like for ALA patients?
Recovery involves monitoring for complications. After appropriate treatment, most patients improve and can be discharged in good condition, often without residual abscesses.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Amoebic Liver Abscess with Hepatic Encephalopathy: A Case Report”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Gupta:
Gupta is a common Indian surname, mentioned in the context of research regarding amoebic liver abscess. It likely refers to a contributor in medical studies, emphasizing collaboration in the field of hepatology, particularly concerning the diagnosis and treatment of infections caused by Entamoeba histolytica.
2) Fever:
Fever is a significant clinical symptom often associated with infections, including amoebic liver abscesses. In the presented case, the patient exhibited high-grade fever, which can indicate underlying inflammation or infection. Monitoring fever helps gauge the severity of the disease and response to treatment.
3) Study (Studying):
Studying reflects the clinical and research efforts to understand amoebic liver abscess. It implies a systematic approach to gathering insights about presentations, treatment options, and patient outcomes, contributing to the broader medical knowledge that aids in improving patient care.
4) Disease:
Disease denotes a pathological condition characterized by specific symptoms and signs. In this case, amoebic liver abscess represents a parasitic infection leading to liver complications. The text focuses on understanding its complexities, particularly the associations with jaundice and encephalopathy.
5) Joshi (Josi):
Joshi is a name associated with research contributions in the field of tropical medicine, specifically regarding amoebic liver abscess. It reinforces the importance of collaborative research in understanding the manifestations and treatment methodologies for infections endemic to specific regions.
6) Nigam (Ni-gam):
Nigam, a contributing researcher mentioned in the context, implies involvement in studies regarding the epidemiology and clinical features of amoebic liver abscess. References to Nigam's work highlight the ongoing efforts to understand the complications associated with the condition.
7) Arrow:
Arrow indicates a visual aid in the imaging studies (CT scans) that help pinpoint the location of the liver abscess. Such markers enhance understanding by directing attention to key anatomical features, facilitating better diagnosis and management of patients with liver abscesses.
8) Medicine:
Medicine encompasses the field focused on diagnosing, treating, and preventing diseases. In the context of the article, it emphasizes the medical approach to managing amoebic liver abscess, highlighting therapeutic interventions such as anti-amoebic therapy and surgical drainage.
9) Bleeding:
Bleeding refers to the loss of blood, a notable symptom that may arise from complications associated with amoebic liver abscess. In this case, the patient experienced haematochesia, raising concerns about potential vascular compromise or inflammation within the hepatic system.
10) Debility:
Debility signifies a state of physical weakness or incapacity, often caused by severe illness such as an amoebic liver abscess. The article discusses this aspect to underscore the potential complications that can greatly affect a patient’s overall well-being and recovery.
11) Falling:
Falling refers to the history of trauma that the patient experienced prior to symptom onset. It is relevant in the clinical assessment to determine potential complications, such as hemorrhage or abscess formation, as trauma can exacerbate underlying conditions.
12) Kannan:
Kannan is another name relevant in medical research, indicating collaborative efforts to understand amoebic liver abscess. Such contributors help build a comprehensive understanding of the disease, its management, and implications on public health.
13) Sharman (Sarma, Sharma, Sarman):
Sharma, mentioned in relation to studies on amoebic liver abscess, emphasizes the role of diverse researchers in advancing knowledge in this field. Such contributions are essential to refine diagnostic criteria and treatment protocols.
14) Indian:
Indian refers to the nationality associated with the context of the study. It highlights the geographical prevalence of amoebic infections and their clinical manifestations in specific populations, underscoring the relevance of local health challenges.
15) India:
India is the country particularly linked with amoebic liver abscesses, highlighting its endemic presence in certain regions. The mention reflects the public health implications and need for effective medical interventions to manage such infections within the population.
16) Pulse:
Pulse refers to the measurement of heart rate, an important vital sign in assessing the patient's condition. Monitoring pulse is crucial in evaluating the hemodynamic stability of patients presenting with symptoms of severe infections like amoebic liver abscess.
17) Guha:
Guha, as another mentioned contributor, reflects the collaborative nature of research in amoebic liver abscess studies. The contributions of multiple researchers inform clinical practice and enhance understanding of this condition.
18) Suri (Shuri):
Suri represents involvement in the exploration of amoebic liver abscess and its treatment modalities. Contributions from a range of researchers are vital for the development of effective therapeutic strategies within this area of medicine.
19) Bile:
Bile refers to the digestive fluid produced by the liver that can become obstructed in cases of liver abscess. The condition may lead to elevated bilirubin levels, thus contributing to jaundice, a crucial symptom discussed in the case.
20) Sign:
Sign denotes an indication or symptom that assists in diagnosing a condition. Clinical signs such as jaundice, altered sensorium, and abdominal tenderness are essential for identifying the severity of the amoebic liver abscess and guiding treatment.
21) Line:
Line in this context may refer to a diagnostic line of questioning or investigation strategy used in clinical settings. It encapsulates the systematic approach needed for understanding the complex interactions between symptoms and underlying pathological processes.
22) Pain:
Pain indicates discomfort experienced by the patient, which is a common symptom in conditions like amoebic liver abscess. Identifying and managing pain is crucial in patient care to improve quality of life and facilitate recovery.
23) Wolf:
Wolf refers to a contributor cited for knowledge on hepatic encephalopathy. The mention encourages a broader understanding of mental status changes in patients with liver pathology, providing insights necessary for managing related complications.
24) Male:
Male refers to the gender of the patient in the reported case, which underscores the relevance of demographics in clinical presentations of disease. Gender may influence incidence, symptomatology, and response to treatment in infections like amoebic liver abscess.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Amoebic Liver Abscess with Hepatic Encephalopathy: A Case Report’. Further sources in the context of Science might help you critically compare this page with similair documents:
Jaundice, Blood test, SGOT and SGPT, Alcoholic liver disease, Clinical manifestation, Hepatic Encephalopathy, Histological examination, Chest X-ray, Liver function test, Serum bilirubin, Total leukocyte count, Alkaline phosphatase, Altered sensorium, Abdominal examination, Follow up care, High grade fever, Biliary obstruction, Entamoeba histolytica infection, High mortality, Intravenous fluid, Total serum bilirubin, Surgical drainage, Serum glutamic oxaloacetic transaminase, Amoebic liver abscess, Yellowish discolouration, Liver abscess, Hepatic amoebiasis, Computed tomographic scan, Hepatocellular dysfunction, Multiple Amoebic liver abscesses, Percutaneous drainage, CT scan finding.
Concepts being referred in other categories, contexts and sources.