Case report: Huge amoebic liver abscesses in both lobes

Area of Science:

• Hepatology
• Infectious Diseases
• Parasitology

Background:

• Liver abscesses can arise from various etiologies, including bacterial and parasitic infections.
• Entamoeba histolytica is a common cause of amebiasis, potentially leading to extraintestinal manifestations like liver abscesses.
• Abscesses in the left hepatic lobe are less common than in the right lobe.

Observation:

• A patient returning from Africa presented with symptoms suggestive of liver abscesses.
• Surgical drainage revealed significant fluid collection and communication between abscesses in both liver lobes.
• Initial bacteriological analysis was negative, but DNA assay confirmed Entamoeba histolytica.

Findings:

• The patient had extensive hepatic lesions consistent with abscesses in both hemilivers.
• Diagnosis was confirmed by detecting Entamoeba histolytica DNA and specific antibodies.
• Successful treatment involved surgical drainage and administration of anti-amoebic medication.

Implications:

• This case underscores the treatability of amoebic liver abscesses, even when presenting atypically in the left lobe.
• Early and accurate diagnosis, including molecular methods, is crucial for effective management.
• Awareness of Entamoeba histolytica as a causative agent is vital for clinicians managing liver abscesses, particularly in endemic or returning traveler populations.