علاج خراج الكبد الأميبي غير المعقد عند وجود أي علامة من علامات الخطورة العالية

References

DOI: 10.4254/wjh.v16.i3.316

For uncomplicated amebic liver abscess (ALA): Upfront percutaneous drainage (PD) should be considered only in the presence of high risk signs; PD doesn't provide added benefit when ALA size is < 5 cm, and ALA with size > 5 should be treated initially with medical therapy (MT) consisting of anti-amebic drug for 3-5 d before considering PD in case of non-response.

Other indications that warrant consideration of early drainage are: (1) ALA in the left lobe or caudate lobe; (2) a thin rim (< 1 cm) of hepatic parenchyma; (3) Type I ALA, lack of mature wall or signs of impending rupture on imaging; (4) secondary bacterial infection; and (5) an unclear diagnosis between ALA and PLA.

For PD, a percutaneous catheter drainage (PCD) is preferred over needle aspiration, particularly for larger and incompletely liquified ALA.

MTZ has a good hepatic penetration, and when used at a dose of 500 mg to 750 mg three times a day for seven to ten days, it resolves symptoms within 72 h of treatment.