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==Background==
*Fecal oral transmission of Entamoeba histolytica cyst
*Excystation in intestinal lumen
*Trophozoites adhere and colonizes large intestine forming new cysts or invade the intestinal mucosa to cause colitis or abscesses
*Liver abscess-10x more common in men
==Clinical Features==
*Asymptomatic vs. dysentery vs. extraintestinal abscesses
*Intestinal- several weeks of crampy abdominal pain, weight loss, watery or bloody diarrhea
*Liver abscess-fever, cough, RUQ or epigastric pain, right-sided pleural pain or referred shoulder pain +/- GI upset
**Hepatomegaly with tenderness over the liver a typical finding
**Abscess rupture can involve associated peritoneum, pericardium, or pleural cavity
*Extrahepatic amebic abscesses in the lung, brain, and skin are rare

==Differential Diagnosis==
===Dysentery===
*Infectious- Shigella, Salmonella, Campylobacter, E.Coli. 
*Noninfectious- Inflammatory bowel disease, ischemic colitis, diverticulitis, AV malformation.

{{Liver abscess DDX}}

{{Fever in Traveler DDX}}

{{Diarrhea DDX}}

==Evaluation==
*CBC
*Chem
*LFT
*Stool or abscess microscopy
*Stool, serum, or abscess fluid antigen
*Indirect hemagluttination (antibody)
*CT or ultrasound for suspected abscess

==Management==
===Asymptomatic colonization===
*[[Paromomycin]] or Diloxanide

===Colitis===
*[[Metronidazole]]

===Liver abscess===
*[[Flagyl]], [[tinidazole]], [[paromomycin]], or diloxanide
*Consider drainage of abscess if no response to antibiotics in 5 days, abscess > 5cm, or left lobe involvement

==Disposition==
*Home if no complications
==References==
<references/>

[[Category:ID]]
[[Category:Tropical Medicine]]
[[Category:GI]]