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Our patient was noted to have clinical signs and symptoms of the disease. Given the history of chronic alcohol consumption, supported by im- aging and positive serology in an individual from a non-endemic region, we were able to make a diagnosis and manage the patient accordingly, resulting in an appropriate therapeutic response. CONCLUSION Physicians should be aware that amebic liver disease could be seen in patients who have not traveled outside of the United States to endemic regions. With one-third of patients in the United States diagnosed of amebic liver abscess not having visited endemic areas, high index of suspicion should be considered in men with history of alcohol abuse, features of immu- nosuppression, or unexplained weight loss pre- senting with unexplained right-sided abdominal pain. This is likely to be missed in patients who have not visited areas with high prevalence such as the patient in our discussion. Early imaging should be considered in patients with concern- ing symptoms to facilitate a diagnosis and to prevent severe complications like hepatic rupture and peritonitis. These complications may require Medical Board Legal Issues? immediate surgical intervention and have an in- creased risk of mortality. REFERENCES 1. Walsh J.  Prevalence of Entamoeba histolytica infection.  In Ravdin JI, ed. Amebiasis, Human Infection by Entamoeba histolytica . New York, NY: John Wiley & Sons Inc; 1988:93-105. 2. Congly SE, Shaheen AM, Meddings L, Kaplan GG, and Myers RP: Amoebic liver abscess in USA: a population-based study of incidence, temporal trends and mortality. Liver Interna- tional 2011, 31: 1191–1198. 3. Salles JM, Salles MJ, Moraes LA, Silva MC: In- vasive amebiasis: an update on diagnosis and management. Expert Review of Anti-Infective Therapy 2007:pp 893-901. 4. Acuna-Soto R, Maguire JH, Wirth DF: Gender distribution in asymptomatic and invasive am- ebiasis: Am J Gastroenterol 2000; 95:1277- 1283. 5. Seeto RK,Rockey DC, Amebic liver abscess: Epidermiology, clinical features and outcome: West J Med,170(1999),pp 104-109. 6. Ahmad M, Khan AH, Mubarik A: Fatal amoe- bic liver abscess: an autopsy study: J Gastro- enterol Hepatol, 6 (1991), pp 67-70. 7. Peterson KM, Singh U, Petri WA Jr. Enteric amebiasis. In: Tropical infectious diseases: Principles, pathogens, and practice, 3rd ed, Saunders Elsevier, Philadelphia 2011. p.614. 8. Kimura K, Stoopen M, Reeder MM, et al. Am- ebiasis: Modern diagnostic imaging with path- ological and clinical correlation. 1997;32:250- 275. 9. Gupta SS, Singh O, Sabharwal G, Hastir A. Catheter drainage versus needle aspiration in management of large (> 10 cm diameter) amoebic liver abscesses. ANZ J Surg 2011; 81:547–551. 10. Sharma MP, Dasarathy S, Verma N, Saksena S, Shukla DK. Prognostic markers in amebic liver abscess: a perspective study. Am J Gastroen- terol. 1996,91:2584-8. 11. M.P. Sharma, S. Sushma,N. Verma. Long term follow up of amebic liver abscess: Clinical and ultrasound patterns of resolution: Trop Gastro- enterol,16 (1995), pp .24-28. Aircraft Ownership Simplified Life’s a Beach Call Pharmacist/Attorney Darren O’Quinn 1-800-455-0581 ® Call for Details www.DarrenOQuinn.com Little Rock, Arkansas Aircraft Sales Department 501.975.9328 [email protected] 2 3 0 1 C r i s p D r i v e | L i t t l e R o c k Since 1939 | A r k a n s a s | 7 2 2 0 2 NUMBER 11 | c e n t r a l . a e r o MAY 2018 • 257