Fulminant Amoebic Liver Abscess with Pleural Involvement and Fatal Intraperitoneal Rupture: A Case Report

Background:Amoebic liver abscess (ALA) is the most common extraintestinal manifestation of Entamoeba histolytica infection. Although most cases respond to antimicrobial therapy, complications such as rupture into adjacent cavities are associated with high mortality. Case Presentation:A 44-year-old Malaysian woman presented with hepatomegaly, right-sided pleural effusion, and ascites. Thoracentesis yielded chocolate-colored fluid containing numerous E. histolytica trophozoites. Shortly after admission, she developed shock due to rupture of a hepatic abscess into the peritoneal cavity and expired despite resuscitative efforts. Conclusion:This case highlights a rare but catastrophic complication of ALA. Early recognition of extrahepatic spread and prompt aggressive management are critical to improving outcomes.