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Official Journal of the Society to Improve Diagnosis in Medicine (SIDM)

Editor-in-Chief: Graber, Mark L. / Plebani, Mario

Ed. by Argy, Nicolas / Epner, Paul L. / Lippi, Giuseppe / Singhal, Geeta / McDonald, Kathryn / Singh, Hardeep / Newman-Toker, David

Editorial Board: Basso , Daniela / Crock, Carmel / Croskerry, Pat / Dhaliwal, Gurpreet / Ely, John / Giannitsis, Evangelos / Katus, Hugo A. / Laposata, Michael / Lyratzopoulos, Yoryos / Maude, Jason / Sittig, Dean F. / Sonntag, Oswald / Zwaan, Laura

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Entamoeba histolytica liver abscess case: could stool PCR avoid it?

Albert Bernet SánchezORCID iD: https://orcid.org/0000-0002-7373-8749 / Alba Bellés Bellés / Jesus Aramburu Arnuelos / Alfredo Jover Sanz / Eva Sesé Abizanda / Montserrat Vallverdú Vidal / Mercè García González
Published Online: 2019-06-29 | DOI: https://doi.org/10.1515/dx-2019-0006



Liver abscess is the most common extraintestinal manifestation of Entamoeba histolytica. Clinical manifestations could appear after returning from an endemic area or several years after the exposure. The diagnosis usually requires microbiological confirmation.

Case presentation

We present a case of a 55-year-old woman diagnosed with Crohn’s disease treated with immunosuppressive drugs, who was admitted to the Emergency Service with liver parenchyma abscesses. Computed tomography (CT)-guided puncture showed pus, and both Gram staining and fresh parasite visualization were negative. Hepatic pus bacteriological culture was reported as negative and parasite multiplex polymerase chain reaction (PCR) was performed, being positive for E. histolytica. The same PCR was performed on blood, pleural fluid and stool samples, all of them being positive for E. histolytica.


Reviewing the clinical history of this patient, it was observed that parasite detection in three stool samples was negative 2 months before the current admission. Due to the lack of sensitivity of the microscopy techniques, we propose to routinely perform parasite detection in stools using molecular techniques, especially in immunocompromised patients.

Keywords: Entamoeba histolytica; hepatic abscess; intestinal parasites; parasites PCR


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About the article

Received: 2019-02-11

Accepted: 2019-05-07

Published Online: 2019-06-29

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interprion of data; in the writing of the report; or in the decision to submit the report for publication.

Conflict of interest: The authors declare not to have any interest conflicts.

Citation Information: Diagnosis, 20190006, ISSN (Online) 2194-802X, ISSN (Print) 2194-8011, DOI: https://doi.org/10.1515/dx-2019-0006.

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