Amebic abscess and sexual contact

A 57-year-old, previously healthy, Spanish man presented in February 2021 with a one-week history of right upper quadrant (RUQ) abdominal pain and fever. On examination, main findings were a blood pressure of 90/50 mmHg, a heart rate of 105 bpm, a temperature of 37.6°C, jaundice and abdominal pain (RUQ). He referred no significant past medical history and had never traveled outside Europe. On secondary direct questioning during hospitalization, he admitted to previous unprotected contact (including oral-anal sex) with a Brazilian female sex worker. Blood tests revealed an elevated white blood cell count (16 400 cells/ul with 14 700 neutrophils/ul), elevated C-Reactive protein (206 mg/l, normal range 0–5), procalcitonin levels of 18.23 ng/ml (normal range < 0.25 ng/ml), elevated AST, ALT, GGT, alkaline phosphatase and LDH levels (205, 227, 157, 263 and 838 U/l, respectively) with a total Bilirubin of 4.35 mg/dl (HIV, hepatitis B and C and syphilis serology...