Amebic liver abscess with bronchopleural fistula

Area of Science:

• Infectious Diseases
• Tropical Medicine
• Medical Diagnostics

Background:

• Amebic liver abscess (ALA) caused by Entamoeba histolytica is a significant parasitic infection.
• Complicated ALA, such as with bronchopleural fistula, can present with symptoms mimicking severe bacterial sepsis.
• Returning travelers with relevant exposure are at risk for parasitic infections.

Purpose of the Study:

• To highlight the diagnostic challenges of amebic liver abscess with bronchopleural fistula.
• To emphasize the utility of rapid molecular diagnostics in guiding targeted therapy.
• To underscore the importance of considering intestinal amebiasis in specific patient populations.

Main Methods:

• Case report of a returning traveler with amebic liver abscess and bronchopleural fistula.
• Utilized multiplex PCR on abscess fluid for rapid pathogen identification.
• Initiated targeted anti-amebic therapy based on diagnostic results.

Main Results:

• Multiplex PCR confirmed Entamoeba histolytica in abscess fluid.
• Targeted therapy was initiated within 24 hours of diagnosis.
• The patient avoided prolonged and unnecessary broad-spectrum antibiotic treatment.

Conclusions:

• Amebic liver abscess with bronchopleural fistula can mimic severe bacterial sepsis in travelers.
• Multiplex PCR offers a rapid and accurate diagnostic method for Entamoeba histolytica.
• Early diagnosis and targeted therapy are crucial for effective management and preventing antibiotic resistance.