Amebic liver abscess in children

Although amebic liver abscess can be a cause of significant morbidity and mortality in all ages, there are few reports dealing with this entity in children. Twenty-four children with amebic liver abscess, ages ranging between 3 weeks and 14.5 years, were managed at the Aga Khan University Hospital, Karachi, Pakistan, between November, 1987, and October, 1992. The most frequent presentation was high grade fever and right upper quadrant pain, associated with tender hepatomegaly, leukocytosis and an elevated erythrocyte sedimentation rate. The diagnosis was confirmed by elevated indirect hemagglutination titers and ultrasonography of the liver. Unlike the experience in adult patients none of the patients had concomitant jaundice, and significant derangement of liver enzymes was unusual. The abscesses were likely to be solitary (22 of 24 patients). There were no deaths despite a mean delay of 15 days before presentation to our hospital. A high index of suspicion, early institution of metronidazole therapy and aspiration of abscesses with potential to rupture are believed to have contributed to the better outcome in these children when compared with results in previous reports.