title: First case of amebic liver abscess 22 years after the first occurrence.
abstract: A 72-year-old man consulted in November 2012 for abdominal pain in the right upper quadrant. The patient had a history of suspected hepatic amebiasis treated in Senegal in 1985 and has not traveled to endemic areas since 1990. Abdominal CT scan revealed a liver abscess. At first, no parasitological tests were performed and the patient was treated with broad-spectrum antibiotics. Only after failure of this therapy, serology and PCR performed after liver abscess puncture established the diagnosis of hepatic amebiasis. The patient was treated with metronidazole and tiliquinol-tilbroquinol. Amebic liver abscess is the most frequent extra-intestinal manifestation. Hepatic amebiasis 22 years after the last visit to an endemic area is exceptional and raises questions on the mechanisms of latency and recurrence of these intestinal protozoan parasites.
authors.affiliation: Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Nespola
authors.affiliation: Service de Néphrologie et Hémodialyse, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Betz
authors.affiliation: Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France - Institut de Parasitologie et de Pathologie Tropicale, Université de Strasbourg, 67091 Strasbourg, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Brunet
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Gagnard
authors.affiliation: Service de Médecine A, Centre Hospitalier de Sélestat, 67600 Sélestat, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Krummel
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Hansmann
authors.affiliation: Service de Néphrologie et Hémodialyse, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Hannedouche
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Christmann
authors.affiliation: Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France - Institut de Parasitologie et de Pathologie Tropicale, Université de Strasbourg, 67091 Strasbourg, France.
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Pfaff
authors.affiliation: Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France - Institut de Parasitologie et de Pathologie Tropicale, Université de Strasbourg, 67091 Strasbourg, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Filisetti
authors.affiliation: Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Pesson
authors.affiliation: Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France - Institut de Parasitologie et de Pathologie Tropicale, Université de Strasbourg, 67091 Strasbourg, France.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abou-Bacar
authors.affiliation: Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France - Institut de Parasitologie et de Pathologie Tropicale, Université de Strasbourg, 67091 Strasbourg, France.
authors.forename: Ermanno
authors.initials: E
authors.lastname: Candolfi
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced; D000368:Aged; D000913:Antibodies, Protozoan / Q000097:blood; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis; D003951:Diagnostic Errors; D004359:Drug Therapy, Combination; D004748:Entamoeba histolytica / Q000276:immunology; D005602:France / Q000453:epidemiology; D006801:Humans; D008101:Liver Abscess, Amebic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D015125:Oxyquinoline / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D012675:Senegal; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014195:Travel; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects / Q000627:therapeutic use; D014900:West Indies
chemical_list: D000913:Antibodies, Protozoan; D000981:Antiprotozoal Agents; D008795:Metronidazole; D015125:Oxyquinoline; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; C032033:5-methyl-8-hydroxyquinoline; C037665:tilbroquinol