Amoebic liver abscess

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 A 55 year old female R/o Miryalaguda, farmer by occupation came to OPD on 11 January 2022

C/o : stomach pain since 15 days

Hopi :

  •  patient was apparently asymptomatic 15 days back then she started experiencing stomach pain on the right side
  • Insidious in onset, gradually progressive 
  • Pricking type of pain
  • Associated with fever, motions and bloating sensation and pedal edema 
  • Bloating sensation since 20 days
  • Fever - since 15 days with chills, reduced on medication
  • Motions - 3-4 episodes per day, watery in consistentency, relieved after joining hospital
  • Bilateral pedal edema since 15 days
Past history :

  • No similar complaints in the past 
  • No H/o diabetes, hypertension, epilepsy, heart disease, asthma.
  • No H/o surgeries
Personal history :

  • Diet :  mixed
  • Apetite :  reduced
  • Bowel :  motions since 15 days
  • Bladder :  regular
  • Sleep :  adequate
  • Addictions :  occasional toddy drinker
  • No Allergies 
Family history : not significant 

General examination : 

  • Patient is conscious coherent cooperative
  • Moderate built, Moderate nourished 
Pallor present 
No signs of Icterus, cyanosis, clubbing, Lymphadenopathy, pedal edema 

Vitals :
  • Temperature :  afebrile 
  • Pulse rate :  100 bpm 
  • Respiratory rate :  12 cpm 
  • Blood pressure :  120/80 mm of Hg 
Abdominal examination : 
  • Inspection :
  1. Shape of abdomen : distended 
  2. Umbilicus.  : inverted 
  3. No scars, sinuses 
  • Palpation : 
  1. Local rise of temperature : present in right hypochondrium and lumbar region 
  2. Tenderness  : present in the right hypochondrium and lumbar region 
  3. Guarding : present 
  4. Rigidity : present 
  5. No fluid thrill 
  6. Liver is enlarged 
  7. Spleen : soft, non tender 
  • Auscultation : bowel sounds heard 








Respiratory examination : 
  • Normal vesicular breath sounds 
CVS examination : 
  • S1 and S 2 heard, no murmurs 
CNS examination : 
  • Sensory system : normal 
  • Motor system : normal 
Investigations : 



Diagnosis : amoebic liver abscess 

Treatment : 
  • Pantop - i. v  40 mg OD 
  • Zofer - i. v  4 mg BD 
  • Metronidazole - 500 mg tid 
  • Inj ceftriaxone - 1 gm I. V BD 
  • Inj Tramadol - sos 
  • Intravenous fluids 





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