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July 1, 1974

Hepatic Amebic Abscess: Unresponsiveness to Combination of Metronidazole and Surgical Drainage

Author Affiliations

From the Tucson Medical Center (Dr. Stillman), the Department of Internal Medicine, Tucson (Ariz) Hospitals Medical Education Program (Drs. Alvarez and Grube).

JAMA. 1974;229(1):71-72. doi:10.1001/jama.1974.03230390047025

FOUR recent reports have illustrated the failure of large doses of metronidazole to cure hepatic amebic abscesses.1-4 Metronidazole is considered the drug of choice in the treatment of invasive amebiasis.5' In combination with abscess drainage, metronidazole thus far has been uniformly successful in the therapy of hepatic amebic abscess.4,6 A patient with hepatic amebic abscess was recently studied at Tucson Medical Center; the abscess failed to respond to a simultaneous combination of metronidazole therapy and surgical drainage of the abscess.

Report of a Case  A 24-year-old Mexican woman was referred to Tucson Medical Center because of jaundice that developed at childbirth. Two weeks before admission, she experienced onset of pleuritic right flank pain that radiated to the right shoulder. Two days before admission, she became jaundiced, and one day before admission, she gave birth to a stillborn infant. She had not been ill previously except for mild