2018 Volume 15 Issue 6 Pages 678-682
We report a very rare case of amoebiasis, presenting with acute appendicitis and liver abscess. A 45-year-old man visited a nearby hospital because of fever and was administered oral antibiotics for 5 days. But his fever did not re-lieved and he was referred to our hospital. On admission, his temperature was 38.1 degree with elevation of white blood-cell count and serum CRP. CT scan showed a swelling and wall enhancement of appendix and a low density mass, 60 mm in diameter, in the anterior-superior segment of the liver. We started an intravenous administration of SBT/CPZ with a diagnosis of acute appendicitis and subsequent abscess of the liver. Dspite of administration of anti-biotics, his fever continued and we changed SBT/CPZ to TAZ/PIPC and performed echo-guided drainage of the liver abscess on hospital day 4. However, his fever never subsided, therefore, we performed laparoscopic appendec-tomy on hospital day 6 and started an oral administration of metronidazole 1.5 g a day since hospital day 7, doubting an amoebic infection. Anti-amoebic therapy immediately achieved an alleviation fever and we stopped metronida-zole in 10 days. He was discharged on hospital day 18. Amoebiasis was proved by blood examination of antibody ti-ter and pathological examination of appendix.
