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One of the manifestations of diaphragmatic rupture is amebic empyema, with incidence rates of 9 to 62 percent. Rarely are cysts identified in the pleural fluid, sputum or stool.’ The empyemas often respond well to conservative treatment which would include a chest tube, but in some series 20 to 40 percent of the patients required invasive procedures such as rib resection and decortication. All pleural effusions should be evaluated by a thoracentesis to differentiate a reactive pleural effusion, which would require only chemotherapy, from an empyema. Lung abscesses occur in about one third of all the patients* with pleuropulmonary amebiasis, whereas as many as half of the patients may have hepatobronchial fistulas.- A patient with hepatobronchial fistulas may empty the liver abscess by expectorating a large amount of dark-colored sputum. Hematogenous spread of amebiasis to the lung occurs only rarely. It occurred only twice in 733 patients from four published series. Emetine, previously regarded as treatment of choice for pleuropulmonary amebiasis, was extremely effective but toxic, and now metronidazole is regarded as such since it is as efficacious but less toxic. However, in rare cases of metronidazole failure, emetine is the drug of choice. Emetine causes pain at the injection site, nausea, muscular weakness and myocarditis. The patient receiving emetine should be on absolute bed rest.