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To the Editor.—
The case of repeated amebic liver abscess reported by Jenkins and Hargrove (232:277, 1975) is extremely interesting. If the details of therapy in the case report are accurate, I believe that the most probable reason for the occurrence of three separate abscesses over a period of years was failure to eliminate the intestinal infection. The doses of emetine hydrochloride and chloroquine were adequate for the cure of each of the abscesses; they cannot be expected to cure the intestinal infection. The first treatment included tetracycline, which can only be relied on to cure if combined with diiodohydroxyquin. The second treatment is said to have included the latter drug but only at a dosage of 650 mg daily, instead of three times a day. Only emetine and chloroquine were used in the third treatment. Either diiodohydroxyquin plus tetracycline or paromomycin sulfate should have been added.
Shookhoff HB. Amebic Liver Abscess. JAMA. 1976;235(14):1426. doi:10.1001/jama.1976.03260400014013