Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Online ISSN : 1882-5133
Print ISSN : 1345-2843
ISSN-L : 1345-2843
Case Reports
A case of amoebic liver abcess in a compromised host
Kunihiro HIROSETakayuki HANAMOTOYuui ISHIGUROShusaku TAKAHASHIYutaka SAJI
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2013 Volume 74 Issue 4 Pages 998-1002

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Abstract
A 57-year-old man who had been treated with chemotherapy after surgery for a left testicular tumor at the urological department in our hospital was seen at our department because of right lower abdominal pain and fever. The WBC count was 39,490/mm3 and the CRP level was 21.78mg/dl, showing increased inflammatory reaction. Abdominal CT scan revealed inflammatory findings at the right side colon. Following administration of antibiotics, his clinical course was observed but no remission was gained. Right hemicolectomy was thus performed on the fifth hospital day. Even after the operation no responses to antibiotics were noted. Abdominal CT scan performed on the forth postoperative day showed extensive multiple liver abscesses. He died on the tenth postoperative day. Histopathology of the resected specimen disclosed amoebae. Many patients with amoebic infection are asymptomatic and in about 10% of them, amoebae invade the intestine to cause enteric amebiasis. Although the mechanism of the onset has been obscure, the uses of steroids and anticancer drugs are pointed out as factors to provoke the disease on the side of the hosts. In the case of an immuno-compromised host who is on adjuvant chemotherapy and resultantly is prone to infection, like our case, a possibility that his or her amoebic infection can rapidly progress is suggested.
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© 2013 Japan Surgical Association
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