goodduck

[intro]
1. amebiasis: infected by E. histolytica 
2. infectied -> 90% -> asymptom
                         10% -> dysentery, liver abscess..etc
# free-living amebas
1. N. fowleri
2. Acanthamoeba

[amebia liver abscess]
1. intestinal colonization -> portal veinous system (resistant to complement-mediate lysis)-> 
    netrophil infiltration -> neutrophil lysis -> neutrophil toxin -> hepatocyte necrosis -> abscess
2. abscess: rim -> congested hepatocyte
                      necrosis hepatocyte (anchovy paste, few or no cell )
                      #  ameba near capsule of abscess

[S&S]

[Lab]

[Dx]
1. aspiration: 
     a. acellular, proteinaceous debris , consisting predominantly of necrotic hepatocytes.
         -> anchovy paste, chocolate colored fluid
     b. Trophozoites seen < 20 % , only in the peripheral parts of the abscess    
2. indirect hemagglutination (IHA) : most sensitive

[Questions]
1. Murphy's sign false positive?
2. Knocking pain false positive?
3. WBC don't shift to left <-- chronic?