Amebic Liver Abscess Diagnosed by Polymerase Chain Reaction in 14 Returning Travelers

Dorothée Vallois Infectious and Tropical Diseases Department, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology laboratory, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology Laboratory, Groupe Hospitalier St. Antoine, Paris, France

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Loïc Epelboin Infectious and Tropical Diseases Department, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology laboratory, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology Laboratory, Groupe Hospitalier St. Antoine, Paris, France

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Feriel Touafek Infectious and Tropical Diseases Department, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology laboratory, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology Laboratory, Groupe Hospitalier St. Antoine, Paris, France

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Denis Magne Infectious and Tropical Diseases Department, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology laboratory, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology Laboratory, Groupe Hospitalier St. Antoine, Paris, France

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Marc Thellier Infectious and Tropical Diseases Department, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology laboratory, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology Laboratory, Groupe Hospitalier St. Antoine, Paris, France

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François Bricaire Infectious and Tropical Diseases Department, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology laboratory, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology Laboratory, Groupe Hospitalier St. Antoine, Paris, France

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Eric Caumes Infectious and Tropical Diseases Department, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology laboratory, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology Laboratory, Groupe Hospitalier St. Antoine, Paris, France

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the ALA-PCR Working Group Infectious and Tropical Diseases Department, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology laboratory, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Mycology and Parasitology Laboratory, Groupe Hospitalier St. Antoine, Paris, France

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Amebic liver abscesses (ALA) are not commonly described in travelers. The ALA diagnosis is usually based on serology and Entamoeba histolytica polymerase chain reaction (PCR) is a new tool. We retrospectively reviewed all ALA cases diagnosed by PCR on the liver abscess pus aspirate of patients admitted in French hospitals between 2007 and 2011. Fourteen cases (10 male, median age 48 years) were included. The median lag time between return and onset of symptoms was 23 days (interquartile range [IQ] 18–24). All patients had an elevated cardiopulmonary resuscitation level, and 11 had leukocytosis. The ALA was multiple in five patients, localized in the right lobe in 12, and higher than 5 cm in 11. Serology was initially negative in one patient, whereas PCR was positive. There was bacterial co-infection in one patient. The outcome was good. Liver puncture allows a rapid diagnosis of ALA with PCR and helps identify the association with a bacterial dual infection.

Author Notes

* Address correspondence to Loïc Epelboin, Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Pitié-Salpêtrière, 47-83 bd de l'Hôpital, 75013 Paris, France. E-mail: epelboincrh@hotmail.fr
ALA-PCR working group: Gilles Pialoux (Infectious and Tropical Diseases Department, Groupe Hospitalier Tenon); Jacques Cosnes (Gastroenterology and Nutrition Department, Groupe Hospitalier St. Antoine); Pierre-Marie Girard (Infectious and Tropical Diseases Department, Groupe Hospitalier Antoine); Fabrice Ménégaux (Digestive Surgery Department, Olivier Soubrane (Visceral and Liver Transplant Surgery Department, Groupe Hospitalier St. Antoine); Emmanuel Tiret and Pierre Balladur (Digestive and General Surgery Department, Groupe Hospitalier St. Antoine); Georges Audry (Visceral Paediatric Surgery Department, Groupe Hospitalier Trousseau), and Luc Paris (Mycology and Parasitology Laboratory, Groupe Hospitalier Pitié-Salpêtrière).

Authors' addresses: Dorothée Vallois, Loïc Epelboin, François Bricaire, and Eric Caumes, Infectious and Tropical Diseases Department, Groupe Hospitalier Pitié-Salpêtrière, Paris, France, E-mails: dvallois@yahoo.com, epelboincrh@hotmail.fr, francois.bricaire@psl.aphp.fr, and eric.caumes@psl.aphp.fr. Feriel Touafek and Marc Thellier, Mycology and Parasitology Laboratory, Groupe Hospitalier Pitié-Salpêtrière, Paris, France, E-mails: feriel.touafek@psl.aphp.fr and marc.thellier@psl.aphp.fr. Denis Magne, Mycology and Parasitology Laboratory, Groupe Hospitalier St. Antoine, Paris, France, E-mail: denis.magne@sat.aphp.fr.

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