Pathogenesis of Amoebic Liver Abscess

In this article, we will discuss the Pathogenesis of Amoebic Liver Abscess. So, let’s get started.

Pathogenesis

Liver abscess is always preceded by amoebic intestinal involvement which may be symptomatic or asymptomatic. Trophozoites invade the veins in the intestine by lysis of the wall and reach the liver through portal circulation. Pathogenic strains are resistant to complement-mediated lysis- a property which makes them survive in the bloodstream. In contrast, nonpathogenic strains are rapidly lysed by complement and thus restricted to the bowel lumen. The active trophozoites in the liver incite inflammatory reaction consisting predominantly of neutrophils. Later, the neutrophils are lysed by contact with amoebae and release of neutrophil toxin that may contribute to necrosis of hepatocytes. The liver parenchyma is replaced by necrotic material that is surrounded by a thin margin of congested liver tissue. The oozing of blood from the vessel into necrotic tissue makes the liver abscess- a classical anchovy paste- called anchovy sauce like pus but the color of fluid is variable with treatment and is composed of bacteriologically sterile granular debris with few or no pus cells. Trophozoites, if seen, tend to be found only near the walls of the abscess.