All are true about Amoebic liver abscess except: March 2007

Ans. B: Alcoholics are susceptible to develop amoebic liver abscess Amebic liver abscess is the most frequent extraintestinal manifestation of Entamoeba histolytica infection. This infection is caused by the protozoa Ehistolytica, which ascends the poal venous system. The right lobe (posterior superior quadrant) of the liver is more commonly affected than the left lobe. This has been attributed to the fact that the right lobe is supplied predominantly by the superior mesenteric vein, whereas the left lobe is supplied by the splenic vein. Histologic Findings of abscess The abscess contains acellular proteinaceous debris and is surrounded by a rim of amebic trophozoites invading tissue. The abscess contains a chocolate-colored fluid that resembles anchovy paste and consists predominantly of necrotic hepatocytes. Complications Pleuropulmonary infection is the most common complication. Cardiac involvement results following the rupture of an abscess involving the left lobe of the liver. It usually is associated with very high moality. Intraperitoneal rupture occurs in 2-7% of patients. Left lobe abscesses are more likely to progress to rupture because of their later clinical presentation. Bacterial superinfection can occur.