A late complication of Entamoeba histolytica infection is a liver abscess; which symptom is typically present?

• A. Cough
• B. RUQ pain
• C. Diarrhea
• D. Jaundice

Answer: (B)

When Entamoeba histolytica spreads beyond the intestine to form a liver abscess, the typical presentation is irritation of the liver capsule with right upper quadrant pain. The parasite reaches the liver via the portal circulation after an intestinal infection, creating a focal abscess most often in the right lobe. This causes localized tenderness and pain in the RUQ, often with fever and hepatomegaly. Diarrhea is more characteristic of the intestinal form and isn’t the defining feature of a hepatic abscess. Cough isn’t typical unless there’s thoracic involvement, and jaundice only occurs if bile flow is affected, which is not the common presentation. So, RUQ pain is the hallmark symptom of an amebic liver abscess.