Massive perianal ulceration: Entamoeba histolytica and Candida albicans co-infection

Although Entamoeba histolytica, named for its notorious tissue-lysing facility, is a major cause of morbidity and mortality worldwide, cutaneous involvement is rare. Presentation in nonendemic countries is exceptionally rare.1 We present a case of amebiasis cutis presenting as a deeply invasive perianal ulceration. Delayed diagnosis, empiric use of broad-spectrum antibiotics, and systemic corticosteroids provided fertile ground for Candida albicans co-infection. This case highlights the tissue destructive nature of E histolytica and the potential for candidiasis to potentiate this tissue destruction.