First case of amebic liver abscess 22 years after the first occurrence

Area of Science:

• Medical Parasitology
• Infectious Diseases
• Hepatology

Background:

• Hepatic amebiasis, a common extra-intestinal manifestation of Entamoeba histolytica infection, typically occurs in individuals with recent travel to endemic regions.
• Delayed diagnosis and treatment can lead to severe complications.
• Understanding the long-term latency and recurrence patterns of amebiasis is crucial for effective patient management.

Observation:

• A 72-year-old man presented with right upper quadrant abdominal pain.
• Initial CT scan revealed a liver abscess; broad-spectrum antibiotics were administered without improvement.
• Subsequent serology and PCR on abscess fluid confirmed hepatic amebiasis, 22 years after his last travel to an endemic area.

Findings:

• Diagnosis of hepatic amebiasis was established late, following initial treatment failure.
• The case demonstrates an exceptionally long latency period for amebic liver abscess.
• Effective treatment involved metronidazole and tiliquinol-tilbroquinol.

Implications:

• This case challenges conventional understanding of Entamoeba histolytica latency.
• It underscores the importance of considering amebiasis in patients with liver abscesses, even with remote travel history.
• Further research into the mechanisms of protozoan parasite latency and recurrence is warranted.