Amoebic Liver Abscess: simultaneous intestinal and hepatic infection

Abstract

Amoebic liver abscess is the most common extraintestinal manifestation of Entamoeba histolytica infection. We report the case of a 27-year-old man from Cape Verde presenting with a one-month history of right upper quadrant pain, diarrhoea, and weight loss. Contrast-enhanced abdominal computed tomography demonstrated a large hepatic abscess. Stool examination identified Entamoeba cysts, while PCR for E. histolytica was positive in both stool and liver abscess aspirate; serology was also positive. The patient was treated with metronidazole followed by paromomycin, achieving complete clinical recovery and radiological resolution after 9 months. This case highlights the importance of considering amoebic liver abscess in patients from endemic regions and emphasizes the value of stool PCR as a rapid, non-invasive diagnostic tool, particularly when percutaneous drainage is not indicated or feasible.