A case of amebic liver abscess was treated in which the abscess was not visualized by hepatic ultrasonography, thus delaying the diagnosis and initiation of appropriate therapy. The abscess was surgically drained because of imminent rupture. Postoperatively, the patient was unable to take oral medications and was successfully treated with intravenously administered metronidazole. Hepatic ultrasonography should not be relied on to rule out liver abscesses. We suggest that parenteral metronidazole should be considered as an alternate therapy to dehydroemetine in patients who are not able to take oral medications.
(Arch Intern Med 141:132-134, 1981)