A rare association of amoebic liver abscess and hepatitis E: Case report

Amoebiasis is a global disease, which is caused by the protozoan Entamoeba histolytica. This infection affects nearly 10% of the population of the developing world. Hepatitis E predominantly affects young adults in the age group of 15-40 years. Both these infections are usually related to contamination of water. We are reporting a rare case of co-infection of amoebic liver abscess with Hepatitis E, in a patient who presented with complaints of high grade fever, yellowish discolouration of eyes and pain in the right upper abdomen. In this patient laboratory investigations showed significantly elevated liver enzymes and conjugated hyperbilirubinaemia. Ultrasound scan of the abdomen revealed a liver abscess. Amoebic serology was positive. He was treated with 'Ceftriaxone' and 'Metronidazole'. Due to persistent elevation of liver enzymes, a viral hepatitis panel was sent which showed Hepatitis E IgM (ELISA) positive. With treatment, his symptoms resolved and the elevated liver enzymes normalised.