Recurrent amoebic liver abscess in a non-endemic region: A case report with dual diagnostic approach

Entamoeba histolytica infection can range from asymptomatic intestinal amoebiasis to more severe conditions such as invasive colitis or hepatic abscess. Amoebic liver abscess (ALA) remains a significant health issue in the tropical region.

We describe the case of a 45-year-old male from Algeria who had traveled to sub-Saharan African regions endemic for amoebiasis. Upon his return, he presented with an ALA, which was diagnosed via ultrasound and MRI, and supported by strongly positive amoebic serology. Multiplex PCR testing of liver abscess fluid confirmed the presence of E. histolytica and, parasitological examination of stool samples revealed Entamoeba histolytica/dispar trophozoites and cysts. Two years later, the patient experienced a relapse of ALA. Herein, we analyse the clinical and epidemiological factors linked to recurrence.

Although Algeria is not considered a region with high amoebiasis prevalence, cases of ALA with relapse -such as the one described- have been documented in several non-endemic areas. Most affected individuals have a history of travel to, or residence in, endemic areas prior to returning to their non-endemic location, as was the case for our patient.