Patient with myelodysplastic neoplasm and giant amoebic liver abscess imported from Italy complicated by intestinal obstruction: a case report and review of the literature.

Abstract

Infection with Entamoeba histolytica is widespread and cosmopolitan, but is particularly common in hot zone countries in areas with poor sanitary and hygienic conditions, a lack of access to safe drinking water, and noncompliance with food hygiene. Currently, no cases of indigenous E. histolytica infections have been registered in Poland; only cases imported from areas with a hot climate zone have been reported. So far, no severe extraintestinal amoebiasis has been diagnosed in Poland in people returning from the Mediterranean area. We report an unusual case of concomitant large liver abscess complicated by small bowel obstruction in an Italian immigrant with chronic myelodysplastic leukaemia who had been in Poland for 10 years. The patient did not present with clinical symptoms of colitis like diarrhoea. The patient had not travelled outside Europe and had never been in tropical areas. The clinical course of the infection, the results of imaging, laboratory, serological and parasitological tests, and the therapeutic methods used are discussed in detail. Attention is drawn to the need to consider amoebiasis and its dangerous complications in the differential diagnosis of abdominal pain and pathological space-occupying lesions in the liver of unknown etiology in people returning from travel to the Mediterranean climate.