[Amebic liver abscesses developing during R-CHOP chemotherapy in a patient with mantle cell lymphoma]

Area of Science:

• Oncology
• Infectious Diseases
• Gastroenterology

Background:

• A 51-year-old man diagnosed with stage IV mantle cell lymphoma received R-CHOP chemotherapy.
• Continuous fever post-chemotherapy prompted further investigation.

Observation:

• Abdominal CT revealed three low-density liver lesions.
• Percutaneous drainage fluid tested positive for Entamoeba histolytica via PCR, despite negative cultures.

Findings:

• The patient had a history of an 8-month stay in Lesotho 21 years prior.
• Entamoeba histolytica infection was diagnosed as the cause of liver abscesses.
• Metronidazole treatment resulted in complete cure.

Implications:

• This case highlights the potential for long-term asymptomatic Entamoeba histolytica colonization reactivating during immunosuppression.
• Early PCR diagnosis is crucial for identifying parasitic infections when cultures are negative.
• Management of lymphoma patients requires vigilance for opportunistic infections, especially after corticosteroid therapy.