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Amoebic liver abscess — DTM&H MCQ

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EasyProtozoal infectionsAmoebic liver abscessDTM&H

A 40-year-old man returns from India with fever and right upper quadrant pain. Ultrasound shows a solitary right-lobe liver abscess, and there is no marked jaundice. What is the most appropriate treatment?

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Correct answer: B — Metronidazole followed by luminal agent

Metronidazole followed by luminal agent is the single best answer because amoebic liver abscess needs tissue-active nitroimidazole therapy followed by eradication of luminal cysts. Cefalexin alone is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that routine aspiration is not needed when the presentation and response are typical.

Reference: Manson's Tropical Diseases; WHO neglected tropical diseases guidance; CDC DPDx