Abstract
A case of amoebic liver abscess complicating diabetes mellitus is reported. A 51 year-old male was hospitalized on March 30, 1994, because of anorexia and high fever. He had never been abroad, and there was no known history of homosexuality. A stool specimen was ++ positive for occult blood. The results of blood examinations were as follows; erythrocyte sedimentation rate, 50mm per hour; white-cell count, 17600/μl, ; GOT, 19; GPT, 25;γ-GTP, 127IU/l; CRP, +++ positive; blood glucose, 243mg/dl; and HbA1c, 7.7%. Abdominal echography revealed a round, nonhomogeneous, low echoic area in the right lobe of the liver. A hyposorbent area (7.5×6.5×10cm) was seen on CT scan. Administration of Cefotaxime was not effective, so percutaneous transhepatic abscess drainage (PTAD) was performed. On microscopical examination, Entamoeba histolytica was detected in pus from the abscess. He died on April 4, despite Metronidazole being administered briefly after the differential diagnosis. The clinical course and prognosis of this patient might have been influenced by immunodeficiency due to diabetes. We emphasize the possibility of an increase in similar cases because the incidences of entamoebiasis and diabetes mellitus have recently been increasing.
