Hepatic Amoebiasis with Superimposed (Secondary) Infection

Amoebiasis is not only one of the most common parasitic infection affecting the hepatobiliary system, it is also the most aggressive and therefore, a leading cause of death especially in most tropical and developing countries in which the prevalent ignorance, poverty, malnutrition and suboptimal sanitation increased the susceptibility. There is increased morbidity and mortality when there is a superimposed infection. Superimposed infection in cases of amoebic liver diseases are not only rare (as few cases are reported in literature), they are associated with increased morbidity and mortality. We hereby discuss a fatal case, seen at our centre and review the radiological assessment and literature to emphasize the fact that high index of suspicion is needed to promptly made the diagnosis and profer treatment. The patient was a 40 year old adult with history of abdominal pain and fever who had ultrasound, full blood count and liver function test done and initial diagnosis of amoebic liver abscess was made but died within 48 h of presentation despite commencement of treatment. Postmortem examination revealed there was a superimposed bacteria infection.