Amoebic Hepatic Abscess with Bronchohepatic Fistula

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PLEURALPNEUMONIC involvement comprises the most frequent complication of amoebic hepatic abscess. The majority of the cases result from rupture or direct extension of the liver abscess through the diaphragm into the pleural cavity. The diagnosis of hepatic amebiasis and possible concomitant pulmonary complications depends primarily upon the awareness of the great possibility of liver involvement following amoebic colon infections. The following case report is an example in which, because of the high index of suspicion, the diagnosis of amebiasis was initially made. In this patient bronchohepatic fistula developed from an amoebic liver abscess and the patient dramatically recovered on a regimen of antiamoebic treatment and closed drainage.

Case Report

A 54-year-old man of Italian descent when first examined at the Cleveland Clinic was complaining of right chest pain and fever of two months’ duration. For the previous thirty years, the patient had noticed occasional loose stools but had had no other symptoms until the onset of his acute illness. Two months before examination, he had noticed constant dull right-sided lateral neck and shoulder pain accompanied by fever; this pain was aggravated by inspiration, coughing, or straining at stool. He had felt fatigued and warm, perspired a great deal. He had lost 24 pounds since the onset of his acute illness and was profoundly weak. A few days after the initial chest pain, he began to have daily diarrhea with two to four watery stools which did not contain bright blood or mucus. For the four weeks previous to the initial. . .



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