阿米巴大腸炎併發肝膿瘍：一病例報告

Amebic Colitis Complicated with Liver Abscess: A Case Report

唐公正(Kung-Jeng Tang) ； 伍偉華(Wai-Wah Ng) ； 張榮和(Rung-Ho Chang) ； 林瑜崇(Yu-Chung Lin)

《內科學誌》 18卷4期 (2007/08) Pp. 195-200

https://doi.org/10.6314/JIMT.2007.18(4).04

摘要

阿米巴原蟲會造成腸道、腸道外感染，臨床上會出現腹瀉、腹痛等急、慢性大腸炎的症狀或以無症狀的帶原者來表現，腸道外感染最主要的是造成肝膿瘍。我們報告的這名49歲男性病人，因為血便、腹痛、發燒而就診，藉由大腸鏡及間接血液凝集試驗(IHA)檢查，診斷為阿米巴大腸炎，這名患者的危險因子為HIV感染。病人的肝生化檢查發現GOT，GPT，ALK-P，GGT升高，因此安排了腹部超音波的檢查，而發現有肝膿瘍的併發症。病人接受metronidazole治療後，他的大腸炎症狀改善，肝膿瘍也完全消失。目前他已經追蹤2年了，阿米巴感染並沒有復發的跡象。

關鍵字

阿米巴原蟲 ； 阿米巴大腸炎 ； 阿米巴肝膿瘍

並列摘要

Amebic infection, which presented as acute diarrheal symptom or asymptomatic chronic carrier status in the intestinal infection, is caused by the protozoa Entamoeba histolytica. It can also induce extra-intestinal infection. Liver abscess is the most common among them. We report a case of amebic colitis complicated with liver abscess, presenting with bloody diarrhea, abdominal pain and fever. Initial diagnosis was from patient's history, clinical symptoms, and colonoscopic findings, whereas we finally diagnosed on positive Indirect hemagglutination test ＞1:512. The risk factor in this patient is HIV infection. Ultrasound of abdomen was conducted because of abnormal liver function tests and it revealed liver abscess. In an amebic colitis victim with impaired liver function, abdominal ultrasound is helpful in making an early diagnosis. After prompt antiamebic treatment with metronidazole, patient's bowel symptoms subsided, and the liver lesions resolved without drainage.

並列關鍵字

Ameba ； Amebic colitis ； Amebic liver abscess