Hepatic amoebiasis, clinical aspects

Upon physical examination there is fever and pain in the liver region (pain upon palpation or percussion). The pain increases during deep inspiration or coughing. If the volume of the abscess is significant, the liver will be enlarged and the diaphragm will be elevated (percussion, auscultation, chest X-ray). The patient may develop pain in the right shoulder (referred pain). Dullness upon percussion of the base of the right lung may be due to the elevation of the diaphragm, to reactive pleural fluid or breakthrough to the pleura, or to atelectasis of the lung. Jaundice is only a very late symptom. The abscess continues to spread until there is breakthrough to the surroundings: the pleura (empyema), the lung, the pericardium or the skin. If fistulisation to the skin occurs, there may be swift progression of a painful skin ulcer. Death follows if not treated.

Category: Medicine Notes