Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Amebic liver abscess (ALA) is a serious, but readily treatable form of hepatic infection. In order to understand the clinical features of this condition in the United States, we reviewed the medical histories of 56 patients with ALA at two large San Francisco Hospitals from 1979 to 1994. Patients were divided into the following groups based on the presumed manner in which they had acquired ALA: those born or raised in the United States, with a history of travel to an endemic area (Tr-ALA); those from an endemic area, but living in the United States for less than one year (En-ALA); and those neither from nor having traveled to an endemic area (N-ALA). We found distinct clinical patterns in patients from different epidemiological groups. Patients with Tr-ALA were a decade older than those from endemic regions, were more likely to be male, and tended to have an insidious onset. Furthermore, compared to patients with En-ALA, those with Tr-ALA were more likely to have hepatomegaly (P < 0.0001) and large abscesses (ALA > 10 cm; P < 0.01). One third of the patients studied had no associated travel history or endemic origin as risk factors. Of these, 63% had a condition consistent with severe immunosuppression, such as infection with the human immunodeficiency virus (HIV), malnourishment with severe hypoalbuminemia, or chronic infection. In patients with N-ALA, the presence of a presumed immunosuppressed state increased significantly, as compared to patients with endemic or travel risk factors for ALA. During the last five years of the study, one third of all patients diagnosed with ALA were HIV positive (including 2 with a new diagnosis of AIDS), many of whom were discovered to be HIV-infected only after presentation with ALA. We conclude that travel to and origin in an endemic area are important risk factors for the development of ALA, and patients in these different epidemiological groups appear to have distinct clinical features. Further, in the absence of recognized risk factors, the development of ALA may suggest an immunocompromised host.
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PMID:Amebic liver abscess: epidemiology, clinical features, and outcome. 1006 97

Amebic liver abscess (ALA) had previously been endemic in Taiwan, particularly in the southern region, although its occurrence in the southeastern area was unknown. Thus, we conducted a retrospective study for southeastern Taiwan. We identified 14 patients who were diagnosed with ALA between July of 1995 and July of 2008. These patients were predominantly male and older in age. Most patients lived in rural areas (85.7%). Alcoholism (78.6%) and diabetes (35.7%) were risk factors for ALA. No human immunodeficiency virus (HIV) infections were detected. The most common clinical symptoms were fever (100%) and abdominal pain (100%). Short mean durations of symptoms, high bilirubin levels, and low albumin levels were also noted. Most patients (92.86%) had a single lesion, particularly in the right liver lobe (71.4%). Six patients also had secondary Klebsiella pneumoniae bacterial infections. Clinicians should be aware of the different risk factors in different regions when diagnosing amebic liver abscess in Taiwan.
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PMID:Clinical manifestations and risk factors of amebic liver abscess in Southeast Taiwan compared with other regions of Taiwan. 2416 42

Amoebic liver abscess is the most frequent extra-intestinal manifestation of Entamoeba histolytica infection. Immunosuppression is known to predispose to amoebic liver abscess. Although amoebic liver abscess is seen more commonly in patients of Human-Immunodeficiency virus (HIV), first presentation of HIV sero-positive patient as multiple liver abscess is quite uncommon.The author reports an unusual case of multiple liver abscesses in an HIV seropositive patient. This middle aged male with history of multiple unprotected sexual encounters presented with spasmodic abdominal pain, fever, diarrhoea and weight loss along with generalised ill-health and painful liver enlargement. HIV-1 serology was found to be reactive. Imaging revealed an enlarged liver with multiple, irregular, hypoechoic foci characteristic of abscesses. Amoebic aetiology was later confirmed by percutaneous aspiration and microscopy. Administration of appropriate chemotherapeutics along with institution of antiretroviral therapy led to both clinical resolution as well as disappearance of lesions.
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PMID:Multiple Amoebic Liver Abscess As Initial Manifestation in Hiv Sero-Positive Male. 2626 51