Amoebic liver abscess: a case report from Santiago, Chile.

Abstract

Liver abscess is a focal suppurative process, mainly of pyogenic and/or amoebic aetiology, the latter caused by the protozoan Entamoeba histolytica. Infection by this parasite in Chile has a prevalence of 3 to 18%. The infection is generally asymptomatic; however, 10% of cases present with symptoms, frequently diarrhoea and abdominal pain. Among the extraintestinal manifestations, amoebic liver abscess stands out. The diagnosis is made through serial parasitological and serological techniques for intra- or extraintestinal manifestations, respectively. Treatment of amoebic liver abscess consists of amoebicides and early drainage. Methodology: We present the case of a young, healthy male patient with epidemiological risk factors for infection due to living in areas of high Entamoeba endemicity and exposure to non-potable water. A literature review was conducted on liver abscess and its correct clinical therapeutic approach, with an emphasis on amoebic aetiology, in relation to the case. Results: The patient presented with a clinical picture characterised by fever, abdominal pain in the hypogastrium radiating to the epigastrium and right chest and shoulder, as well as changes in bowel movements. Imaging revealed a large, single liver abscess suggestive of amoebic origin. It was treated empirically with a dual antibiotic regimen while awaiting the results of serology for Entamoeba histolytica, which were positive. Discussion: The patient responds well to treatment, with no complications. Conclusion: The importance of diagnostic and therapeutic precision is emphasised, including luminal eradication of the parasite, a treatment that is not yet available in Chile, given the current migratory context in the country.