title: An uncommon case of hepatopulmonary amoebiasis.
abstract: Amoebiasis is an uncommon infection in developed countries caused by the protozoan Entamoeba histolytica. Amoebic liver abscess is the most frequent extraintestinal presentation of the disease; pleuropulmonary involvement is rare, occurring mostly by rupture of the abscess into the pleural space or lung parenchyma. We describe a case of a 48-year-old migrant from São Tomé e Príncipe, with fever, wasting, dry cough and right upper abdominal pain for the past 2 months. The CT scan revealed a voluminous liver abscess with thrombosis of the right suprahepatic and inferior vena cava, right pulmonary lobar abscess and multiple diffuse condensations in both lungs. Aspirated pus resembled anchovy sauce; blood and aspirated material cultures for infectious agents were negative. Serology for E. histolytica was positive, and the diagnosis of hepatopulmonary amoebiasis with infectious phlebitis was confirmed by positive PCR in the liver pus. Treatment with metronidazole+paramomycin led to clinical and radiological resolution.
authors.affiliation: Department of Internal Medicine, Hospital de Santo António dos Capuchos, Lisboa, Portugal.
authors.forename: Catarina
authors.initials: C
authors.lastname: Patrício
authors.affiliation: Department of General Surgery, Hospital de Santo António dos Capuchos, Lisboa, Portugal.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Amaral
authors.affiliation: Department of Radiology, Hospital de Santo António dos Capuchos, Lisboa, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Lourenço
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016054:DNA, Protozoan / Q000032:analysis; D003937:Diagnosis, Differential; D004748:Entamoeba histolytica / Q000235:genetics*; D004749:Entamoebiasis / Q000175:diagnosis* / Q000469:parasitology; D006801:Humans; D008101:Liver Abscess, Amebic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008169:Lung Abscess / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D016054:DNA, Protozoan