Dyspnea and Dysentery: A Case Report of Pleuropulmonary Amebiasis

Merica Shrestha, MD; Anita Shah, DO; Christopher Lettieri, MD

Disclosures

South Med J. 2010;103(2):165-168. 

In This Article

Abstract and Introduction

Abstract

Pleuropulmonary amebiasis is an uncommon complication of Entamoeba histolytica infection. It typically occurs in endemic regions including Central and South America, Africa and the Indian subcontinent. The case of a previously healthy US Army male stationed in Liberia with an acute onset of fevers, abdominal pain and bloody diarrhea is presented. He developed a productive cough with pleuritic chest pain and imaging revealed multiple liver abscesses, with rupture through the diaphragm causing a large right pleural empyema. A positive Entamoeba histolytica serum antibody and pleural fluid antigen confirmed the diagnosis. Surgical drainage of the pleural empyema and medical treatment with antiparasitics were necessary for symptom and disease resolution.

Introduction

Entamoeba histolytica is the third leading cause of parasite-related mortality worldwide causing over 100,000 deaths annually.[1] This disease is most commonly seen in developing countries or in travelers to endemic regions, particularly Central and South America, Africa and the Indian subcontinent. This parasite primarily causes intestinal damage through fecal-oral ingestion of amebic cysts. The cysts develop into trophozoites in the lumen of the small intestine and can rupture through the mucosa, directly invading other organs.

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