THE RECOGNITION AND TREATMENT OF HEPATIC AMEBIASIS

Abstract

Seven cases are reported in detail. Helpful diagnostic aids are: (1) tender and often enlarged liver, (2) fading suntan complexion of the skin, (3) elevation of fixation of the right hemldiaphragm,(4) little or no change in liver function tests, (5) positive complement fixation test, with a fall in titer following amebicidal therapy, and (6) specific therapeutic response. The treatment of 28 hospital patients with amebiasis is reviewed. All except 2 patients had intestinal lesions and parasites in the stools, and 6 had liver abscesses. Chloroquine and emetine are available for the treatment of extraintestinal amebiasis; both are specific for amebic hepatitis and abscess. Chloroquine''s high therapeutic effect and lack of toxicity render it superior to emetine. The advantages of combined therapy using chloroquine and diodoquln are emphasized. The 2 untreated patients died. Three out of a group of 15 patients treated with intermittent or alternating therapy had a total of 7 relapses. There were no relapses in the group which received combined therapy.