Autochthonous amebiasis in Spain

Amoebiasis is an infection caused by the intestinal protozoan Entamoeba histolytica. It is transmitted via the faecal-oral route and primarily affects the intestinal tract and the liver. It is prevalent in tropical countries but is uncommon in Europe, where it is typically diagnosed in immigrants and tourists from endemic regions. However, an increase in autochthonous cases is being observed in Spain. A case is presented of a 56-year-old Spanish male with no relevant epidemiological history who attended the Emergency Department due to right hypochondrial pain and fever. An abdominal CT scan revealed circumferential mural thickening in the caecum and a large cystic mass in the right hepatic lobe. The study was completed with a colonoscopy, which showed ulcers with an infectious appearance in the caecum and right colon (biopsies were non-diagnostic), and an abdominal ultrasound, which characterised the hepatic lesion as an abscess. An ultrasound-guided drainage was performed and a sample was sent to Microbiology, which tested positive for Entamoeba histolytica. He received empirical antibiotic therapy with ceftriaxone and metronidazole, resulting in a favourable clinical outcome.