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Amebic Pericarditis Consequent to Amebic Abscess of Right Lobe of the Liver

Report of a Case

A 48-year-old black man, a garbage collector, was admitted to hospital in North Carolina because of pain in the upper portion of the abdomen of about 3 months' duration. His liver extended from about the fourth intercostal space to 1 cm above the iliac crest. There was also evidence of pleural effusion and atelectasis at the base of the right lung, and of pericarditis. Within 4 days after admission, cardiac tamponade occurred. Pericardiocentesis on 3 consecutive days yielded a total of about 1,100 ml of seropurulent fluid in which motile trophozoites of Entamoeba histolytica were found. Aspiration of the liver abscess yielded 300 ml of reddish purulent material; no E. histolytica were recovered. Treatment with metronidazole (Flagyl®), 750 mg thrice daily, was begun on the 1st hospital day and continued for 18 days. Chloroquine phosphate (Aralen®), 500 mg twice daily, was begun on the 7th hospital day and continued for 19 days. The patient recovered rapidly thereafter and was discharged 28 days after admission. Examination 22 weeks after discharge indicated recovery except for persistent abnormalities of the liver.

Accepted for publication June 24, 1972.

^* Present address: Monroe Community Hospital, Rochester, New York 14620.