A 28-year-old man has a 10 cm amoebic liver abscess confirmed by positive Entamoeba histolytica serology. He has been on appropriate metronidazole therapy for 7 days with persisting fever and increasing pain. Which feature is itself a recognized indication for ultrasound-guided aspiration?
- A Serology positivity at presentation
- B Abscess located in the left lobe of the liver ✓
- C A single abscess less than 5 cm in diameter
- D Presence of multiple small abscesses
Correct answer: B. Abscess located in the left lobe of the liver
Explanation
Most amoebic abscesses resolve with metronidazole alone, so aspiration is reserved for selected situations: failure to improve after 5 to 7 days of therapy, a left lobe abscess where rupture into the pericardium threatens life, a very large abscess, or diagnostic uncertainty. Left lobe location is therefore both a recognized primary indication and consistent with this patient's failed medical course. Serology supports diagnosis but never mandates drainage by itself.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.