Amebic Liver Abscess: Epidemiology, Laboratory Diagnosis, Clinical Manifestations, and Nursing Management-An Updated Review

Abstract

Background: Amebic liver abscess is the most common extraintestinal manifestation of infection caused by Entamoeba histolytica. It remains a major public health problem in developing regions with inadequate sanitation and unsafe drinking water. The disease primarily affects adults, particularly males aged 18 to 50 years, and is associated with significant morbidity and potential mortality if complications occur. Aim: This review aims to provide an updated and comprehensive overview of amebic liver abscess, focusing on epidemiology, pathogenesis, clinical presentation, laboratory diagnosis, management strategies, complications, and the role of nursing and multidisciplinary care in improving patient outcomes. Methods: A structured narrative review approach was used, synthesizing published literature on amebic liver abscess, including epidemiological studies, clinical guidelines, and recent evidence on diagnostic and therapeutic approaches. Information was organized into thematic sections covering etiology, pathophysiology, clinical features, imaging, laboratory diagnosis, treatment, complications, and healthcare team involvement. Results: The review highlights that E. histolytica is transmitted via the fecal–oral route and leads to hepatic involvement through portal circulation spread. Clinical presentation typically includes fever, right upper quadrant pain, and systemic symptoms. Diagnosis relies on serology with high sensitivity and imaging modalities such as ultrasound, CT, and MRI. Metronidazole followed by luminal agents remains the standard treatment, with most patients responding within days. Percutaneous or surgical intervention is required in complicated cases. Despite favorable prognosis in uncomplicated disease, rupture and extrahepatic spread significantly increase mortality risk. Conclusion: Amebic liver abscess is a preventable and treatable condition with excellent outcomes when diagnosed early and managed appropriately. Strengthening public health measures, improving sanitation, and promoting multidisciplinary healthcare collaboration are essential to reduce disease burden and prevent complications.