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. 2020 Sep 11;20(1):295.
doi: 10.1186/s12876-020-01440-7.

A rare hepatic mass in an Italian resident

Matteo Borro  1   2 , Giuseppe Murdaca  3 , Monica Greco  3 , Simone Negrini  3 , Maurizio Setti  3
Affiliations

A rare hepatic mass in an Italian resident

Matteo Borro et al. BMC Gastroenterol. .

Abstract

Background: Amebiasis is a rare condition in developed countries but epidemiologically growing. Clinical manifestation may range from asymptomatic to invasive disease, amoebic liver abscess being the most common manifestation. We report a peculiar case of left hepatic amoebic liver abscess in a patient without a well-known source of infection and presenting with left portal vein thrombosis.

Case presentation: Patient, working as longshoreman, presented with complaints of remittent-intermittent fever lasting from 2 weeks. Physical examination was normal. Blood tests showed mild anemia, neutrophilic leukocytosis and elevated inflammation markers. Chest x-rays was normal. Abdominal ultrasound showed multiple hypoechoic liver masses. CT-scan of abdomen showed enlarged left liver lobe due to the presence of large abscess cavity along with thrombosis of left portal vein. The indirect hemagglutination test for the detection of antibodies to Entamoeba histolytica (Eh) was positive. Ultrasound-guided percutaneous drainage revealed "anchovy sauce" pus. Metronidazole and a follow up imaging at 3 months showed resolution of abscess cavity.

Conclusion: This case shows that amoebic liver abscess is possible even in first world country patients without travel history. Left sided abscess and portal vein thrombosis are rare and hence reported.

Keywords: Amebiasis; Amebic liver abscess; High-risk behavior; Multiple pseudo-nodules; Portal vein thrombosis; Sepsis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Panel a: CT-scan showing enlarged left liver lobe due to the presence of a single large loculated abscess cavity. Panel b: CT-scan performed 3 months later showing a normal liver structure
Fig. 2
Fig. 2
Panel a: Coronal image with Maximum Intensity Projection reconstruction showing signs of left portal vein thrombosis. Panel b: Coronal image with Maximum Intensity Projection reconstruction performed 3 months later and showing a restored left portal vein flow
See this image and copyright information in PMC

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