Salmonella enterica and Entamoeba histolytica co-infection presenting as multiple liver abscesses in an immunocompetent patient

Abstract

People living with the human immunodeficiency virus (PLHIV) are likelier to have Salmonella infections and bloodstream invasion than immunocompetent people. Here, we present a case with liver abscess due to co-infection Entamoeba histolytica and Salmonella enterica with no co-morbidities, immunocompromised states or any alcohol or other substance abuse history. A 36-year-old male with no significant co-morbidities presented with complaints of abdominal pain and fever. On examination, the right hypochondrium was tender without guarding or rigidity. Amoebic serology was positive. Stool culture isolated Salmonella group B and abscess culture revealed Salmonella enterica. HIV serology was negative. The ultrasound revealed hepatomegaly, two well-circumscribed abscesses in the liver, with right-sided pleural effusion. The patient was managed with ultrasound-guided pigtail drainage, followed by antibiotic therapy. Even though the co-infection of Salmonella and Entamoeba leads to abscess in immunocompetent individuals, which is rare, we should not overlook the possibility of the diagnosis.