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Amebiasis. A persistent problem.

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 laboratory 2 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 abscess 2 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