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"Multiple Liver AbscessLiver abscess is a public health problem in few countries in Asia, Africa, and South America. As time goes, there were only few cases of amebic liver abscess found in developed countries, on the contrary more pyogenic liver abscess are found in those countries. Liver abscess could be caused by bacteria, parasite, or fungus J. The common symptoms among the liver' abscess are fever; chill, fatigue, loss of appetite, weight loss, right upper' abdominal pain,? in a few cases have symptoms like coughing, hiccup, pain in low right chest, or' pain on the shoulder: We reported a male patient 38 years batak ethnic was admitted with major symptoms such as high lever follow by chill, right upper abdominal pain, nausea, vomiting, appetite loss, fatigue and sometimes coughing. Based on clinical, laboratory data, and abdominal USG found this patient suspected suffered from pyogenic liver abscess. Treatment of this pattern consist of antibiotic (cefotaxime 29x1 IV metronidazol 3x500mg orally and aspiration of the liver' abscess). Aspiration was done 2 times with the interval l week, extracted 260cc totally yellow greenish watery fluid with no smell. On the follow up abdominal USG was repeated on January 8, 2003 found enlarge of the liver; 3 small abscesses on the right lobe liver and so recovery process and then patient left the hospital in good condition after 3 weeks hospitalized."

"Pyogenic liver abscess may have serious complications that need specific management. We reported a case of a young male patient aged 24 years old and complained of abdominal enlargement since 2 (two) weeks before. Abdominal ultrasound revealed multiple liver abscesses. Liver aspiration was performed and about 500 cc of yellowish purulent fluid was drained. During hospitalization the symptoms of fever and shortness of breath were getting worse although adequate antibiotic treatment had been given. Chest X-ray examination showed elevated right hemidiaphragm and right pleural effusion. Thoracocentesis and proof puncture showed purulent fluid. He was diagnosed with empyema as a complication of pyogenie liver abscess. Water Sealed Drainage (WSD) was performed to evacuate the fluid and he was given antibiotics. The patient's condition improved in several days."

"ABSTRAKAmebiasis merupakan penyakit yang umum yang banyak ditemukan di negara berkembang. Namun hanya sedikit yang bermanifestasi klinis menjadi kolitis amuba. Komplikasi yang paling sering dijumpai adalah abses hati amuba. Abses hati selain disebabkan oleh amuba dapat disebabkan oleh bakteri yang dikenal sebagai abses hati piogenik. Untuk dapat menegakkan penyebab abses hati yang disebabkan oleh amuba maka selain anamnesis dan pemeriksaan fisik, dibutuhkan pemeriksaan penunjang seperti pemeriksaan serologi antigen dan antibodi Entamoeba histolytica. Namun pada praktek klinis, jarang sekali pemeriksaan serologi ini dilakukan. Oleh karena itu penelitian ini mencoba untuk melihat profil pasien dengan dugaan abses hati amuba yang sampelnya dikirimkan ke laboratorium parasitologi FKUI untuk pemeriksaan antibodi E. histolytica serta menilai hubungan antara gejala klinis/tanda tersebut dengan hasil serologi. Sampel diambil dari data pasien RSCM yang sampelnya dikirimkan ke laboratorium parasitologi FKUI dengan dugaan abses hati berupa keluhan utama, pemeriksaan fisik dan hasil laboratorium dan hasil serologinya diambil dari hasil pemeriksaan ELISA antibodi Entamoeba histolytica. Hasil penelitian menunjukkan bahwa sebagian besar pasien yang positif serologi antibodi E. histolytica adalah pasien dari kelompok umur 26-45 tahun dan berjenis kelamin laki-laki. Sedangkan manifestasi klinis yang ditemukan pada pasien tersebut dari yang terbanyak adalah hepatomegali, klinis abses hati, nyeri perut, abdominal discomfort, berat badan turun, diare, muntah, efusi pleura dan mual. Yang memiliki hubungan signifikan dengan hasil serologi positif antibodi E. histolytica hanya hepatomegali. Dari data laboratorium ditemukan sebagian besar pasien memiliki hasil laboratorium normal. Namun ada beberapa pasien yang mengalami penurunan hemoglobin dan hematokrit, leukositosis, peningkatan laju endap darah serta peningkatan fungsi hati SGOT dan SGPT.

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ABSTRACTAmebiasis is a common disease that is found in many developing countries. Yet few have clinically manifested as amoebic colitis. The most common complication is an amoebic liver abscess. A liver abscess other than caused by amoeba can be caused by a bacterium known as a pyogenic liver abscess. To be able to determine the cause of liver abscess caused by amoeba, beside anamnesis and physical examination, laboratory examination such as serological antigen and antibody of Entamoeba histolytica is needed. However, in clinical practice, this serology test is hardly performed. Therefore, this study attempted to look at the profile of the patient with suspected liver abscess whose sample was sent to the parasitology laboratory FMUI for E. histolytica antibody examination and assess the association between the clinical signs with serology results. Samples data were taken from Cipto Mangunkusumo hospital patient whose samples were sent to parasitology laboratory FMUI with suspected liver abscess in the form of main complaint, physical examination and laboratory result. Additionally, serology result was taken from antibody of Entamoeba histolytica ELISA examination. The results showed that most of the positive serologically patients of E. histolytica antibodies were patients at the 26 45 age group and from male group. While the clinical manifestations found in these patients subsequently are hepatomegaly, clinical liver abscess, abdominal discomfort, weight loss, diarrhea, vomiting, pleural effusion and nausea. It is only hepatomegaly that has a significant association with serologic positive results for E. histolytica antibodies. From the laboratory data, most patients have normal laboratory results. However, there were some patients who experienced decreased of hemoglobin and hematocrit, leukocytosis, increased blood sedimentation rate and increased liver function of AST and ALT."

"ABSTRAKAbses hepar merupakan lesi inflamasi pada hepar yang dapat menyebar ke ronga pleura sehingga mengakibatkan empiema maupun abses paru. Salah satu penyebab penyebaran ke rongga pleura adalah karena adanya fitsula hepatopleura. Dalam kasus ini, seorang laki-laki, 43 tahun, datang dengan keluhan sesak napas yang memberat sejak 1 minggu yang lalu, disertai nyeri perut bagian atas, batuk darah sebanyak satu kali, perut dirasakan membesar, serta terdapat riwayat merokok, promiskuitas, dan minum alkohol. Pada pemeriksaan fisik, didapatkan paru kanan tertinggal saat inspirasi, vocal fremitus menurun, perkusi redup, dan suara vesikuler menurun pada lapang paru kanan dan hepatomegali. Hasil IDT amoeba adalah 1,92 dan pemeriksaan cairan pleura, didapatkan kesan eksudat. Didapatkan gambaran efusi pleura masif pada foto toraks. Hasil USG hepatologi didapat abses hepar, hepatomegali, dan efusi pleura kanan. Pada pemeriksaan USG Toraks didapat efusi pleura kanan dengan gambaran loculated. CT scan torak dengan kontras didapat gambaran kavitas dengan air-fluid level pada hemitoraks kanan dan lesi segmen 4,5 hepar. Hasil analisis cairan pungsi abses hepar didapatkan pemerikasaan mikrobiologi tidak ditemukan kuman, BTA negatif, kultur tidak ditemukan mikroorganisme maupun kuman anaerob, pemeriksaan patologi didapatkan cairan berwarna coklat kental, dan pemeriksaan mikroskopik didapatkan sediaan sitologi abses hepar yang mengandung massa nekrotik, serta serabut jaringan ikat."