Amoebic liver abscess most commonly affects -

Ans. is 'a' i.e., Right lobe of liver Amoebic Liver abscesso Caused by Entamoeba histolytica whose cysts are acquired through the feco-oral route and their trophozoites reach the liver through portal venous systemo Like pyogenic abscess they are also common in rt. lobe of livero Clinical Picture# the typical clinical picture is of a patient 20-40 yrs of age who has travelled to an endemic area, presents with fever, chills, anorexia, rt. upper quadrant pain.# although liver abscess results from an obligatory colonic infection, a recent history of diarrhoea is uncommon.# jaundice is rare. (c.f. in pyogenic abscess jaundice is seen in -25% of pts.)o Liver function tests may show mild abnormalities, hyperbilirubinemia is uncommono CT > U/S are the mainstay of investigation.o Diagnosis is confirmed by serological tests (enzyme immuno assay) for antiamoebic antibodieso Cultures of amoebic abscess are usually negativeo Treatment# Metronidazole is the mainstay of t/t and is curative in over 90% of patients.(other nitroimidazoles i.e. secnidazole, tinidazole, are also effective)#Therapeutic needle aspiration is avoided. Done only wheno pt. fails to respond to metronidazoleo high risk of ruptureo abscess secondarily infected with pyogenic organismo Complications may occur uncommonly; these are# rupture into the peritoneum, pleural cavity or pericardium.