Diagnosis of Clinically Suspected Amoebic Liver Abscess Using Conventional PCR and Antigen ELISA in Liver Aspirate and Serum

Introduction: Entamoeba histolytica, a protozoan parasite causes the infectious disease amoebiasis.The majority of amoebiasisrelated death are caused by extra-intestinal pathology, the most prevalent of which is an amoebic liver abscess.Here we analyzed the difference between the serological detection of antigens using ELISA and the molecular method using PCR in liver abscess patients. Aim:To validate the diagnosis of clinically suspected cases of Amoebic liver abscess using PCR and/antigen ELISA in liver aspirate and serum samples. Materials and Methods:Liver aspirate and blood samples were collected from 45 clinically suspected ALA patients.Those samples were subjected to microscopy, antigen ELISA, and PCR.The patient's demographic details along with clinical findings were noted and co-related.Here we considered liver aspirate PCR was gold standard and diagnostic accuracy of liver aspirate ELISA, serum ELISA, and serum PCR for identifying E. histolytica was evaluated.Results: It was found that liver aspirate showed positive for E.histolytica DNA in 32 patients (71.1%) by PCR and for antigen in 45 patients (100%) by ELISA respectively.Serum sample showed positive for E. histolytica DNA in 4 patients (8.8%) by PCR and for antigen in 42 patients (93.3%) by ELISA.Our study found that abdominal pain was the chief complaint found in 44 patients (97.7%) followed by fever was seen in 27 patients (60%).Diabetes mellitus was the common co-morbidity (n = 13, 28.8%) followed by hypertension (n = 8,17.7%).Additionally found that 71.1% (n = 32) of patients had a habit of alcohol consumption and 35.5% (n = 16) were chronic smokers. Conclusion:Our study found the importance of utilizing liver aspirate PCR and antigen ELISA for accurate diagnosis of Amoebic liver abscess, especially in patients presenting with typical symptoms and relevant co-morbidities.