Isolated Amoebic Cholecystitis Mimicking Acute Calculus Cholecystitis: A Diagnostic Challenge

Amoebiasis, caused by Entamoeba histolytica , is a major health concern in tropical regions and commonly affects the colon and liver. Although extraintestinal spread occurs in a minority of symptomatic cases, rare sites such as the gallbladder are seldom recognized – especially without hepatic involvement. A 71-year-old woman presented with right hypochondrial pain suggestive of acute cholecystitis. She underwent cholecystectomy, converted to open surgery due to adhesions. Histopathology revealed E. histolytica trophozoites within the gallbladder wall, confirming amoebic cholecystitis. No hepatic abnormalities were seen on preoperative imaging. This case represents an unusual instance of isolated amoebic cholecystitis, a rarely reported extraintestinal manifestation. Although the liver is involved in most extraintestinal cases, atypical sites such as the pleura, brain, and gallbladder can be affected. Accurate diagnosis requires histopathological confirmation, as imaging may not reliably distinguish parasitic causes of cholecystitis. In endemic settings, clinicians should maintain a high index of suspicion for rare extraintestinal manifestations of amoebiasis. Histopathology remains crucial for definitive diagnosis and guiding appropriate antiparasitic therapy.