[Amebic liver abscesses in Yaoundé]

Abstract

Until 1985, morbidity and mortality from amebic infections were high in sub-Saharan Africa (2). The aim of this work was to describe the clinical, diagnostic and prognostic aspects of amebic liver lesions in a large town in tropical Africa, seven years after the last study of this disease in the area. We studied 96 amebic liver abscesses in 77 patients in a study with prospective and retrospective components. The patients were aged 20 to 65 years and the diagnoses were made on the basis of clinical radiological and biological criteria. Most of the patients were men (3:1). The most frequent clinical signs and symptoms were: pain on (100%), fever (92.2%), enlarged right hypochondrium (89.6%), heptomegaly (45.4%) and weight loss (39.6%). Ultrasound scans showed that the abscesses were most frequently found in the liver, on the right-hand side (65.6%) and that they were 20 to 125 mm in diameter. Between 80 and 2,500 ml of pus was drained from each abscess. We found pleuropulmonary lesions in 10.4% of cases. Serological tests for amebae were strongly positive in almost all cases and HIV tests (carried out prospectively) were positive in 11.6% of cases. The amebic liver lesions appeared to be primary in 66% of cases. The patients were treated with metronidazole, combined if necessary, with drainage under ultrasound surveillance. Two of the patients died. The others were completely cured after a mean of 13 days in hospital. Amebic infestations are cosmopolitan in nature. They occur most frequently in tropical areas. Amebic infections are rife in tropical Africa, with a prevalence of 1 to 2% (1). Liver amebiasis is the principal form of amebic infection outside of the intestine. Liver amebiasis is often detected at the stage of abscess formation.