Amebic liver abscess in children.

Five children with amebic liver abscesses are presented, and the distinctive clinical and laboratory features for these and 119 other children are described. The majority (91%) were less than 3 years old, and 77% had an isolated abscess in the right hepatic lobe. Each child presented with a history of fever and gastrointestinal symptoms, and two-thirds presented with cough or difficulty breathing. Most (81%) patients had hepatomegaly on physical examination and some had a well-defined mass. Hematologic abnormalities including anemia, neutrophilia and an increased ratio (greater than 0.15) of immature neutrophils to total neutrophils were commonly observed at the time of admission. Of interest, intravenous pyelograms revealed deviation of the right kidney due to hepatomegaly in each of three children studied. All patients evaluated had one or more filling defects demonstrated by liver-spleen scan or abdominal ultrasound. Most patients underwent either an open (9%) or closed (77%) drainage procedure. Fifty-six children (46%) died, in some cases before specific therapy was instituted. Of those who recovered all received therapy with metronidazole or a combination of chloroquine with emetine or dehydroemetine.