A 63-year-old man with invasive amoebiasis mimicking pulmonary tuberculosis

Entamoeba histolytica is an intestinal protozoan parasite transmitted through the faecal–oral route. Up to 90% of E. histolytica infections are asymptomatic or associated with mild symptoms. Most cases in Canada are from residents of or travellers from areas of high endemicity, although autochthonous cases have been reported among men who have sex with men (MSM) and Canadian Indigenous populations. We present an uncommon case of amoebic liver abscess with diaphragmatic perforation and intrapulmonary extension mimicking active pulmonary tuberculosis. Amoebic liver abscesses are infrequently seen outside of endemic areas, rarely extend outside the liver, and should be suspected in cases of unexplained fever even in the absence of signs, symptoms, or basic blood tests suggestive of liver pathology.