Cutaneous Amebiasis of the Eyelid with Extension into the Orbit *

A 4-month-old girl was admitted to hospital with extensive ulceration and erosion of the left eyelid where 17 days earlier the skin had been broken when hit by a ball. Despite antibiotic therapy the lesion expanded to involve the orbit. Biopsy of the eyelid on the 4th day in hospital, and examination of the eye and attached tissues removed on the 6th. failed to detect amebae until after the infant's death due to a blood transfusion 2 weeks later. Reexamination of the tissues revealed abundant amebae with characteristic morphology of Entamoeba histolytica in subcutaneous tissues of the biopsy and in the loose exudate and necrotic tissues attached to the eye at all levels from lids to base.