ABSTRACT
Total 9 cases of extraintestinal amoebiasis, amebic liver abscess and amebic lung abscess, were treated with metronidazole. The diagnosis and progress check were done by (1) stool examination, (2) size and pain of liver, (3) hematological examination, (4) urinanalysis, (5) X-ray or liver scanning (6) examination of aspirated pus from liver and (7) immobilization test of E. histolytica. Results are summarized as follows: Amebic hepatitis: Metronidazole was given to 3 cases with daily dose of 0.9-1.2 gm for 3-7 days. Clinical symptoms were completely restored by the treatment. Amebic lung abscess: One case was treated with metronidazole for 3 days with the daily dose 1.2 gm. X-ray findings showed remarkable improvement by the treatment. An additional administration of the drug for 6 days resulted complete resolution of the pneumonic changes. Amebic liver abscess: Four cases were treated with metronidazole. The daily doses were 0.4-2.4 gm and continued for 2-10 days. Aspiration of the abscess for 1-10 times or continuous drainage of pus were performed during the course supplementarily. All cases were recovered to normal by the combining treatment. No remarkable side effect was noticed by the drug administration, and no relapse was experienced up to date.
Subject(s)
Drug Therapy , Metronidazole , Liver , Lung , AmebiasisABSTRACT
Clinico-pathological, parasitological, microbiological and immunologic studies were made in 238 of islanders Cheju, a highly endemic area of amebiasis in Korea. Ameba immobilization test was carried out using immunized rabbit sera and several strains of Entamoeba histolytica. The results are summarized and concluded as follows; I. The number of males with liver abscess was markedly greater than female, and the largest group distribution was observed in ages 30-39. In liver abscess patients, an increase of white blood cells(W.B.C.) and a decrease of red blood cells'R.B.C.) was noted. The differential count of W.B.C. showed an increase of segmented neutrophils and a decrease of 1ymphocytes. The level of total cholesterol and its ester was also diminished, and urobilinogen in patients, urine was increased in comparison with healthy controls. 2. The detection rate for microorganisms in aspirated liver abscess was 42.1%. Most of the recovered microorganisms were Gram negative enteric bacilli; Escherichia coli, Alkaligenes fecalis, Aerobacder aerogenes and paracolon group. Fungi and cocci were not observed. 3. In the immobilization test using immune rabbit sera immunized with a 48-hour-culture of E. histolytica, the highest immobilization reaction occurred 45-105 minutes after the beginning of the test and remobilization of the parasite took place gradually. Immobilization of ameba continued for more hours and at higher rate in the inactivated rabbit sera group, and the differences among ameba strains were not remarkable. In human amebiasis sera, the highest peak of immobilization reaction occurred at 45-90 minutes after testing with the parasite. 4. Positive rates for the immobilization test according to clinical feature were 83.3-100% in liver abscess cases, 83.3-90.7% in hepatomegaly cases, 45.4% in asymptomatic cyst-passers and 31.5% in healthy controls. 5. For 56 patients who showed a high rate of immobilization, the follow-up positive rate after treatment for amebiasis was markedly reduced in 2-3 months.