Amoebic liver abscess differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]

Overview

Amoebic liver abscess must be differentiated from other diseases that cause fever, [[pain, cough, jaundice, hepatomegaly

Differential Diagnosis

Disease	Causes	symptoms												Lab Findings	Imaging Findings	Other Findings
		Fever	Pain			cough	Hepatomegaly	Jaundice	Weight loss	Anorexia	Diarrhoea or Dysentry	Nausea and vomiting	Stool
			Abdominal pain	Pleuritic pain	Aggravating/ relieving factors
Amoebic liver abscess	Entamoeba histolytica	✔✔	✔				✔/✘	✔ (late stages)		✔		✔				More ill appearing than pyogenic abscess More fever than pyogenic Needle aspiration: Fluid from an ALA is odorless,reddish brown anchovy paste
Pyogenic liver abscess	Bacteria Gram-positive aerobes Gram-negative enterics Anaerobic organisms Acid fast bacilli	✔	✔			✔	✔	✔	✔ (acute loss)	✔	✔	✔	Pale/dark	✔
Fungal liver abscess	Candida species
Necrotic hepatoma	Hepatits B virus infection Hepatitis C virus infection Alcohol Oral contraceptive pills
Echinococcal (hydatid) cyst	Echinococcus granulosus
Malignancy (Hepatocellular carcinoma/Metastasis)	Hepatitis B and C Aflatoxins Alcohol Heamochromatosis Alpha 1 antitrypsin deficiency Non alcoholic fatty liver disease