Socioeconomic status, clinical features, laboratory and parasitological findings of hepatic amebiasis patients--a hospital based prospective study in Bangladesh

Abstract

Socioeconomic status, clinical, laboratory and parasitological features of 31 hospitalized amebic liver abscess (ALA) and 8 amebic hepatitis (AH) patients were studied. Thirty-seven (94.9%) of the total 39 cases were from low socioeconomic class and 2 (5.1%) were from middle class (p<0.001). Sixteen (51.6%) ALA and 5 (62.5%) AH patients were admitted with duration of disease for 3 weeks or more. Twenty-one (67.7%) ALA and 3 (37.5%) AH cases gave no previous history of diarrhea or dysentery. Epigastric pain was the predominant symptoms in 71% patients compared to high fever (19.4%), nausea and vomiting (9.7%). Neutrophilic leukocytosis was found in 9 (29.0%) ALA and 2 (25%) AH cases. Raised alkaline phosphatase was the predominant abnormal liver function test found elevated in 22 (71.0%) ALA and 5 (62.5%) AH cases. Three (7.7%) of the 5 (12.8%) microscopy positive stool samples yielded growth of Entamoeba histolytica in culture. The right lobe was involved in 28 (90.3%) ALA cases; 29 (93.5%) patients had single abscess. Bacterial super infection was observed in 1 (12.5%) abscess, reactive changes in right lung was observed in 6 (19.4%) ALA and 1 (12.5%) AH cases. Ascaris lumbricoides was the predominant associated intestinal parasite