A 41-year-old truck driver in northern Italy was found to have two sizable liver abscesses tied to a parasitic infection that is more often linked to poor sanitation in tropical areas, and his doctors suspect the organism may have been passed through sex.
Here's what to know
As Newsweek reported, the man was sent to a hepatology unit after imaging identified two lesions in the right lobe of his liver, one measuring 3.1 inches and the other 2.4 inches.
When physicians drained one of the lesions, they recovered thick, brown, necrotic material. Laboratory work did not find bacteria, fungi, tuberculosis, or malaria.
The liver abscesses made more sense in light of symptoms he had experienced: body lice, severe diarrhea with abdominal cramping, repeated fevers, swelling of the lips and mouth, and a 26-pound drop in weight.
Testing also indicated a separate Borrelia infection, which the doctors thought could be related to the lice infestation.
A clearer explanation emerged only after doctors took a more detailed sexual history. The patient said he had a sexual encounter with a man before the diarrhea started, which prompted the team to test for Entamoeba histolytica, the parasite that causes amoebiasis.
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Two blood samples showed strong antibody positivity for the parasite, and the doctors determined that the patient had invasive amoebiasis with liver abscesses.
Dr. Ayesha Bryant, clinical adviser of Alpas Wellness in Maryland, told Newsweek: "What makes this case significant isn't just because a foreign parasite is found in Italy, but because how the parasite got into the person does not match the way health professionals typically think they get there."
More background
The report describing the case appeared in Infectious Disease Reports in 2026.
The authors said the man got better after two courses of metronidazole followed by paromomycin, and the follow-up imaging found the liver lesions had almost completely cleared.
The usual route of transmission for Entamoeba histolytica is fecal-oral contamination, often through contaminated food or water, though sexual activity involving fecal-oral exposure can also spread it.
On uncommon occasions, the infection extends beyond the intestines and produces abscesses in the liver.
Bryant said this isolated case should not be taken as evidence that people in Italy or Europe are suddenly facing a broad new public health threat.
Even so, the case illustrates how infections can appear outside the regions where they are most often recognized because of travel, migration, and sexual networks.
What can be done?
The report's authors said clinicians should keep sexually transmitted enteric infections in mind when unexplained gastrointestinal symptoms are involved.
Gathering a fuller history of travel, exposures, and sexual activity may help identify unusual infections earlier, before they worsen.
Details such as travel patterns, living conditions, infestations, and sexual contact can all matter when doctors are trying to reach the right diagnosis.
Together, those steps can help clinicians recognize patterns and improve screening for illnesses that fall outside the usual expectations.
Bryant said, "If you are a clinician evaluating someone with persistent unexplained diarrhea — especially if it is accompanied by fever, weight loss or subsequently develops liver abnormalities — you need to obtain a complete travel and sexual history and include sexually transmitted enteric infections on your list of possible diagnoses."
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