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Entamoeba histolytica is one of the most common parasitic infections worldwide, infecting about 50 million people and resulting in 40 000–100 000 deaths a year. In Australia, people at risk of infection include immigrants, travellers returning from countries of high endemicity, Indigenous people, and men who have sex with men. Clinical manifestations range from asymptomatic carriage to invasive disease. Amoebic colitis and amoebic liver abscess are the most common invasive manifestations observed in Australia.
In Dhaka, Bangladesh, where diarrhea is a public health threat among children, approximately 50% of children show serologic evidence of exposure to E histolytica. In the United States and other developed countries, the infection is rare; in these countries, it is most common among persons with a history of travel to or residence in the developing world. The magnitude and the true epidemiology of amebic infection remain unclear.
The role of surgery is generally limited to patients with complications of invasive disease. Surgical drainage is generally unnecessary in amoebic liver abscess, as cure can be achieved with medical therapy alone. The role of radiologically guided percutaneous therapeutic aspiration in uncomplicated amoebic liver abscess is controversial but it has been shown to be of some clinical benefit in patients with large abscesses.
