Absceso hepático amebiano: observaciones sobre siete pacientes

Introducción

Describir las características epidemiológicas, clínicas y microbiológicas de los pacientes diagnosticados de absceso hepático amebiano, cuatro de ellos aparentemente autóctonos.

Métodos

Se revisaron retrospectivamente los casos con absceso hepático amebiano detectados durante el período 1991-2002 en el Hospital Universitario Son Dureta de Palma de Mallorca, hospital de referencia para las Islas Baleares, con 980 camas.

Resultados

Se diagnosticó a 7 pacientes con absceso hepático amebiano. Todos ellos residían en Mallorca. Dos pacientes viajaron a áreas endémicas (la India y Tailandia), otro era un inmigrante procedente de Ecuador. Cuatro pacientes no tenían antecedentes de viajes al extranjero, por lo que podría tratarse de casos autóctonos, si bien esta circunstancia no quedó probada. De los 7 pacientes, dos estaban infectados por el virus de la inmunodeficiencia humana.

Conclusiones

La etiología amebiana debería considerarse en el diagnóstico diferencial de los abscesos hepáticos en nuestro medio, a pesar de la ausencia de antecedentes epidemiológicos.

Introduction

The epidemiological and clinical characteristics of patients with amoebic liver abscess are described.

Methods

Laboratory, clinical, and epidemiological records of all patients with amoebic liver abscess diagnosed from 1991 to 2002 at Hospital Universitario Son Dureta (Palma de Mallorca, Spain), a 980-bed referral hospital in the Balearic Islands, were retrospectively reviewed.

Results

Seven patients were diagnosed with amoebic liver abscesses and all were residing in Mallorca. Two patients had developed the disease after travelling to endemic areas (India and Thailand), and another, from Ecuador, had been diagnosed four months after coming to Spain from his country of origin. In the remaining four patients, no apparent link with endemic areas was observed, nor was travel out of Spain recorded. Therefore, these cases were thought to have originated in Spain, though this circumstance could not be conclusively proven. Two of the seven patients had human inmunodeficiency virus (HIV) infection.

Conclusions

An amoebic etiology should be considered in the differential diagnosis of liver abscess in our area, even in the absence of a clear related epidemiological history.