Letter to the Editor: An optimum diagnostic test for amoebic liver abscess in endemic areas: are we there yet?

Madam, Entamoeba histolytica, a protozoan parasite, causes a spectrum of diseases in man. The most common extra-intestinal manifestation of amoebiasis is liver abscess. This entity can cause significant morbidity and mortality particularly when the abscess ruptures into cavities such as pleura, peritoneum, pericardium or organs such as the stomach. Amoebic liver abscess (ALA) is mainly concentrated in the developing countries because of factors such as poor public health, sanitation and personal hygiene. In view of the mortality that can be incurred from the complications associated with ALA, prompt diagnosis and treatment is of utmost importance in improving the survival of patients. Apart from meticulous history and detailed physical examination, imaging and serologic testing are generally included in the investigative work-up of a patient suspected to have ALA. However, imaging modalities are limited by lack of specificity for ALA. This places a higher reliance on serologic tests such as indirect haemagglutination assay (IHA).