Our experience with two cases of amebic hepatic abscess is reported with comments on other published papers.
The patients were both males with homosexuall history, and had the onset with fever of 39°C. They were diagnosed as hepatic abscess by CAT scanning. One of them was performed surgical drainage, developed a hepatic failure, and was referred to the hospital. In both two cases the drainage was accomplished by needling under the guidance of CAT scanning. The diagnosis of amebic hepatic abscess was established on identification of the organism in the pus in one case and by positive serologic test of amebic antibody titers in the other. Metronidazole following drainage was effective for them and the antibody titers went back to normal.
Amebic hepatic abscess has been noticed as one of sexually transmitted diseases (STDs) and has been increasing in the incidence among patients population who had never gone abroad.
Our experience suggests that amebic abscess should be suspected in the cases of hepatic abscess with negative bacterial tests. Hearing the history of homosexuality and serology of amebic antibody are necessary for diagnosis. In the treatment of the disease, the drainage by needling under the guidance of ultrasonic or CAT scanning was effective. Metronidazole should be administered by monitoring the antibody titer as an index.