Unusual presentation of amoebic liver abscess with pseudohaemoptysis

Amoebic liver abscesses, caused by <i>Entamoeba histolytica</i>, can rarely rupture into the pleural space, leading to massive pseudohaemoptysis. We report a case of a patient who presented with severe haemoptysis, later diagnosed with a ruptured amoebic liver abscess. Despite a negative pus culture, a positive <i>E. histolytica</i> IgM test confirmed the diagnosis. The patient was managed with intravenous metronidazole and ceftriaxone, along with pigtail catheter drainage, leading to a full recovery. This case highlights the importance of considering hepatic abscess rupture in unexplained haemoptysis and emphasises the role of serological testing when cultures are inconclusive. Prompt antimicrobial therapy and drainage are essential for optimal outcomes.