Pulmonary amebiasis complicated with massive left empyema and respiratory failure: A case report

Abstract

Introduction: Amebiasis is defined as a parasitic infection with the protozoan Entamoeba histolytica. Amebiasis in pulmonary and pleural tissue is the second common location of extraintestinal amebias is after amoebic liver abscess. Pulmonary and pleural amebiasis happens in 2-3% of invasive amebiasis patients with mortality rate 5-16%. Case: We report a 22-year-old man with the chief complaint of dyspnea for one week. The patient also felt pain in the left chest, had productive cough and fever. He had a history of dysentery one month ago. BGA evaluation confirmed patient had respiratory failure type 1 with PCO2 35 and PO2 46.1. Thoracentesis was performed, the result was brown milk (anchovy paste) color and pleural fluid analysis revealed positive Entamoeba histolytica. Antimicrobial therapy and drainage were given with excellent response. Conclusion: Pulmonary and pleural amebiasis is an uncommon disease, usually occurring on the right side of the lung compared to the left side and rarely causing respiratory failure. Pulmonary amebiasis is a life-threatening, but treatable, condition. Antimicrobial therapy and drainage is an important strategy in pulmonary amebiasis management.