What are the physical findings suggestive of amebiasis?

Updated: Jul 19, 2019
  • Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Patients with acute amebic colitis may have lower quadrant abdominal tenderness (12-85% of cases). Fever is noted in only a minority of patients (10-30%). Weight loss occurs in 40%. Dehydration is uncommon. Occult blood is nearly always present in stools (70-100%). Fulminant amebic colitis is commonly characterized by abdominal pain, distention, and rebound tenderness.

Amebic liver abscess may present with fever (85-90% of cases) and tender hepatomegaly (30-50%). Right lower intercostal tenderness may be elicited, particularly posteriorly (84-90%). Weight loss is noted in 33-50%. Breath sounds may be diminished at the right lung base, and rales may be heard. A small subset of patients has a subacute presentation with hepatomegaly, weight loss, and anemia. Jaundice is unusual (6-10%).

Other physical findings in amebiasis include the following:

  • Pleuropulmonary amebiasis may produce right-side pleural effusions, empyema, basilar atelectasis, pneumonia, and lung abscess

  • Patients with amebic peritonitis have fever and a tender, rigid, and distended abdomen

  • Amebic pericarditis presents with features of congestive heart failure; a pericardial friction rub may be audible

  • Cerebral amebiasis presents with altered consciousness and focal neurologic signs

  • Genital ulcers due to amebiasis have a punched-out appearance and profuse discharge


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