Amebic liver abscess: a 15-year experience.

Amebic liver abscess is increasingly common in the United States, particularly in the West and Southwest, due to increased immigration from Southeast Asia, Mexico, and Central America. The presentation, course, and treatment of 50 patients treated for amebic liver abscess at a county-community hospital in San Jose, California, between 1974 and 1988 is reviewed. The typical patient is an immigrant, usually a Hispanic male, 20-40 yr old, who presents with fever, right upper quadrant pain, leukocytosis, abnormal serum transaminases and alkaline phosphatase, and a defect on hepatic imaging study. Available serologic testing (i.e., indirect hemagglutinin antibody) is sensitive and confirms the diagnosis. Most patients respond rapidly and completely to oral metronidazole. The data, compared with other studies, indicate no major change in presentation or management, except for decreasing need to aspirate the abscess for diagnosis.