Rivera, Windell L., Escueta, Aleyla S., Villacorte, Elena A. , Limlingan, Erly T. , Lazaro, Catherine M. , Kanbara, Hiroji
Amebiasis, the human disease caused by Entamoeba histolytica, may present intestinal or extra-intestinal symptoms. Intestinal amebiasis is reliably diagnosed by microscopic examination of stool samples, rectal scrapes and biopsy. To increase the reliability of microscopy, culture can be done using Robinson's or Inoki's medium. However, diagnosis of invasive extra-intestinal amebiasis (e.g., amebic liver abscess) is more difficult. Collection of samples needs invasive procedures. Diagnosis of amebic liver abscess (ALA) relies on serology. Immunologic studies have demonstrated serum antigenemia and involvement of a humoral anti-amebic antibody response. In this study, we showed that indirect fluorescent antibody test (IFAT) is comparable to the indirect hemagglutination test (IHAT) in the serologic diagnosis of ALA. Descriptive analysis of 101 patients suspected to have ALA by ultrasound confirmed serologically using either IHAT or IFAT showed that the common clinical and laboratory findings of ALA include fever, abdominal pain, malaise, anorexia, weight loss and right upper quadrant abdominal tenderness. Ultrasound results showed hepatic abscess in the majority of the patients. Abscess usually presented as a complex mass and occurred mostly in the right lobe of the liver. Furthermore, white blood cell count, liver enzyme levels, alkaline phosphatase and transaminase levels (SGOT and SGPT) were elevated. Among the age groups, adult males 41-50 years of age were commonly affected with ALA.