Abstract
The patient was a 43-year-old Pakistani man who had lived in Japan for 16 years. He presented at our hospital with abdominal pain and fever. His temperature was 39.4°C and blood biochemistry tests showed increased WBC and CRP levels as well as elevated levels of liver and biliary system enzymes. CT showed multiple abscesses in the liver. Although treatment was started with antibiotics, no improvement was observed. Thus, the abscesses were punctured on day 3. The culture results were negative and no ameba was detected. After drainage, the fever subsided and his hematological parameters returned to normal. Colonoscopy showed multiple small ulcers in the right side of the colon. As Giardia lamblia was then detected in the washing solution, oral administration of metronidazole was started. After the patient was discharged, CT showed that the abscesses had decreased in size, colonoscopy showed disappearance of the ulcerous lesion in the appendix, and Giardia lamblia was undetectable.
