Molinié C, Daly J P, Essioux H, Burlaton J P, Bernard J, Lesbordes J, Laverdant C
Ann Med Interne (Paris). 1980;131(6):343-5.
Two cases of hepatic amoebic abscesses are reported as having relapsed--one three times, the other twice--after from several weeks to several months of apparent cure by mitronidazole, without recontamination. The following hypothesis can be eliminated: resistance of E. histolytica to metronidazole, poor absorption or faulty diffusion of the drug, its possible inactivation. The persistance of amoebae in the digestive tract, even if they are not detected, seems probable however: either because they are situated in such a way as to be inaccessible to the active metabolities of the metronidazole or because the intra-luminal concentration of these metabolites is not sufficient. The fact that the intestinal parasitism repeatedly leads to the constitution of successive hepatic abscesses in the same person presupposes the privileged anatomic situation of a colonic ulceration which brings about reiterated dissemination through the portal veinous system.
据报道，有两例肝阿米巴脓肿患者在接受甲硝唑治疗数周或数月后，表面上已治愈，但在未再次感染的情况下复发——一例复发三次，另一例复发两次。以下假设可以排除：溶组织内阿米巴对甲硝唑耐药、药物吸收不良或扩散不佳、药物可能失活。然而，消化道中阿米巴的持续存在，即使未被检测到，似乎是有可能的：要么是因为它们所处的位置使甲硝唑的活性代谢产物无法到达，要么是因为这些代谢产物在肠腔内的浓度不足。肠道寄生虫感染反复导致同一人发生连续的肝脓肿，这一事实预先假定了结肠溃疡的特殊解剖位置，它通过门静脉系统导致反复传播。
