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Byline: G. Harms (1), J. Zenk (2), S. Martin (3), M. Kokozidou (3), W. Puschel (4), U. Bienzle (1), H. M. Seitz (3) Keywords: Key Words Leishmaniasis; Localized lymphadenopathy; Leishmania infantum/chagasi Abstract: A 25-year-old female patient presented with an isolated cervical lymph node enlargement several months after having returned from Spain and Latin America. She had no other signs or symptoms of disease. Leishmania infantum/chagasi was identified as the causative agent. With extended travel activities localized lymph node enlargement due to leishmanial infection should be included in the differential diagnosis of lymphadenopathy of unknown origin. Author Affiliation: (1) Institute of Tropical Medicine and Medical Faculty Charite, Humboldt Universiy Berlin, Spandauer Damm 130, D-14050 Berlin, Germany e-mail: gundel.harms@charite.de, DE (2) Dept. of Otorhinolaryngology, Head and Neck Surgery, Saarland University, Homburg/Saar, Germany, DE (3) Institute of Medical Parasitology, Bonn University, Bonn, Germany, DE (4) Dept. of Pathology, Saarland University, Homburg/Saar, Germany, DE Article note: Received: July 5, 2000 * Revision accepted: August 27, 2001

A 38-year-old male German traveller returning from Asia presented with fever, night sweats and abdominal complaints. Abdominal ultrasonography revealed several fast-growing abscesses of the liver. Three blood cultures as well as serologic investigations for the detection of antibodies to Entamoeba histolytica, performed on day 3 and 7 after the onset of clinical symptoms, remained negative. Stool microscopy revealed the presence of amoeba cysts compatible with E. histolytica infection. Taking both the amoebic and bacterial etiology of the abscesses into consideration, the patient was treated with metronidazole and ciprofloxacin followed by paromomycin. Antibodies to E. histolytica tested positive shortly after anti-amoebic therapy was initiated. The patient fully recovered, and ultrasound follow-up showed complete resolution of the abscesses within 50 days. This case leads to the conclusion that amoebic liver abscess should be considered despite negative amoeba serology and that ultrasonography is an important diagnostic tool for the early diagnosis of extraintestinal amoebiasis. [ABSTRACT FROM AUTHOR]