Disseminated amoebiasis in pregnancy: A maternal near-miss

Abstract

Disseminated amoebiasis in pregnancy, though rare, can be life-threatening and mimic bacterial sepsis or inflammatory bowel disease (IBD). We report a case of maternal near-miss at 18 weeks of gestation due to amoebic colitis and liver abscess. The woman presented with fever, bloody diarrhoea, and abdominal pain, initially suspected to be bacterial sepsis, and treated with ceftriaxone. Ultrasound revealed hepatic abscesses and caecal thickening. Following massive rectal bleeding and hypovolemic shock, colonoscopy confirmed Entamoeba histolytica infection. Liver abscess drainage yielded anchovy-sauce pus, and stool, blood, and aspirate cultures were negative. Metronidazole therapy led to clinical improvement. This case highlights the importance of considering disseminated amoebiasis in pregnant women with haemorrhagic diarrhoea and sepsis. Early histopathological confirmation and targeted anti-amoebic therapy are essential for effective management, preventing severe complications such as haemorrhagic shock and liver abscess.