The case report in this issue, by Kovaleski and his colleagues (see p 132), raises a number of important questions about the diagnosis and treatment of amebiasis.
The critical clinical problems were (1) the known difficulties in diagnosing invasive amebic disease, and (2) a false-negative ultrasonogram of the liver. It is well established that most patients with amebic liver abscess have negative stool examinations for Entamoeba histolytica.1 In addition, the diagnosis of amebiasis, based on morphologic criteria, is one of the most demanding tests in the clinical laboratory2 and, like other morphologic tests, is inherently insensitive. Thus, this case report both reinforces the value of serologic studies in the diagnosis of amebic liver abscess2 and illustrates problems in the detection of amebic infection that are by no means unique to one institution.
The false-negative ultrasonogram in the patient described by Kovaleski et al raises the question