[A case of pulmonary amebiasis]

Area of Science:

• Infectious Diseases
• Hepatology
• Pulmonology

Background:

• Amebiasis is a parasitic infection typically affecting the liver and intestines.
• Pulmonary involvement is a rare but serious manifestation of amebiasis.

Observation:

• A 57-year-old male presented with dyspnea and right abdominal pain, exhibiting massive right pleural effusion and a unilocular liver cyst.
• Initial treatment for suspected bacterial empyema and liver abscess with antibiotics and drainage was ineffective.
• Diagnosis was revised to amebiasis after negative cultures and patient disclosure of homosexual activity, leading to metronidazole treatment.

Findings:

• A fistula connecting the liver cyst to the right pleural space was identified via contrast medium injection.
• Anti-amebic antibodies tested positive on admission day 21.
• The patient fully recovered after treatment with metronidazole.

Implications:

• This case underscores the necessity of considering amebiasis in the differential diagnosis of unexplained liver abscesses and pleural effusions, particularly in endemic areas or specific risk groups.
• Awareness of rare pulmonary manifestations of amebiasis is crucial for timely and appropriate management.
• Early recognition and targeted therapy can lead to favorable outcomes in complicated amebiasis cases.