Fulminant amoebic colitis is a rare but very dangerous disease caused by the parasite Entamoeba histolytica, which can lead to intestinal perforation and massive internal bleeding. In areas where this infection is not common, diagnosis is often delayed because the symptoms resemble bacterial appendicitis or perforated peritonitis. The article describes the case of a patient with more extensive intestinal necrosis, deep ulcers and damage to blood vessels who underwent surgery to remove the cecum and part of the intestine. The diagnosis was confirmed using modern next-generation metagenomic sequencing (NGS) of blood and abdominal fluid, as well as histopathological examination. Despite emergency surgery and prompt initiation of antiparasitic treatment, the patient developed intractable septic shock and repeated internal bleeding that led to his death. The article emphasizes that NGS can help in the early detection of severe amoebiasis, and that early suspicion and treatment are key to improving the prognosis.