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Background: Painful liver enlargement with fever are common signs of hepatic ambiasis. Exceptionally, atypical signs may also occur including symptoms suggesting renal sepsis., Case Report: An 18-year-old woman from the New Caledonia was hospitalized in metropolitan France for suspected right-sided acute pyelonephritis. Urinalysis was normal and the kidney ultrasound suggested the need for an abdominal CT-scan which evidenced a voluminous 10-cm abscess pus. Serology for amebia was positive, confirming the diagnosis of hepatic amebic abscess. Outcome was rapidly favorable with intravenous anti-parasite treatment amebic abscess. Outcome was rapidly favorable with intravenous anti-parasite treatment and percutaneous drainage., Discussion: Atypical signs of hepatic ambiasis may mislead diagnosis. The absence of a fetid odor at puncture helps guide diagnosis, confirmed by serology. Percutaneous drainage can hbe proposed for voluminous abscesses or if the risk of extrahepatic complications is eminent.