of cases. in fewer cases, the parasite invades the soft tissues, most commonly the liver. only rarely are masses formed (amoebomas) that lead to intestinal obstruction.(mistaken for ca caecum and appendicular mass) other local complications include bloody diarrhea, pericolic and pericaecal abscess. complications of hepatic amoebiasis includes subdiaphragmatic abscess, perforation of diaphragm to pericardium and pleural cavity, perforation to abdominal cavital (amoebic peritonitis) and perforation of skin (amoebiasis cutis). pulmonary amoebiasis can occur from liver lesions by spread through the blood or by perforation of pleural cavity and lung. it can cause lung abscess, pulmono pleural fistula, empyema lung and broncho pleural fistula. it can also reach the brain through blood vessels and cause amoebic brain abscess and amoebic meningoencephalitis. cutaneous amoebiasis can also occur in skin around sites of colostomy wound, perianal region, region overlying visceral lesion and at the site of drainage of liver abscess. urogenital tract amoebiasis derived from intestinal lesion can cause amoebic vulvovaginitis (may's disease), rectovesicle fistula and rectovaginal fistula. entamoeba histolytica infection is associated with malnutrition and stunting of growth in children. epidemiology amoebiasis caused about 55,000 deaths worldwide in 2010, down from 68,000 in 1990. in older textbooks it is often stated that 10% of the world's population is infected with entamoeba histolytica. nevertheless, this means that there are up to 50 million true e. histolytica infections and approximately seventy thousand die each year, mostly from liver abscesses or other complications. although usually considered a tropical parasite, the first case reported (in 1875) was actually in st petersburg in russia, near the arctic circle. infection is more common in warmer areas, but this is because of both poorer hygiene and the parasitic cysts surviving longer in warm moist conditions. history amoebiasis was first described by fedor a. lösch in 1875, in northern russia. the most dramatic incident in the us was the chicago world's fair outbreak in 1933, caused by contaminated drinking water. there were more than a thousand cases, with 98 deaths. it has been known since 1897 that at least one non-disease-causing species of entamoeba existed (entamoeba coli), but it was first formally recognized by the who in 1997 that e. histolytica was two species, despite this having first been proposed in 1925. in addition to the now-recognized e. dispar, evidence shows there are at least two other species of entamoeba that look the same in humans: e. moshkovskii and entamoeba bangladeshi. the reason these species haven't been differentiated until recently is because of the reliance on appearance. joel connolly of the chicago bureau of sanitary engineering brought the outbreak to an end when he found that defective plumbing permitted sewage to contaminate drinking water. in 1998 there was an outbreak of amoebiasis in the republic of georgia. between 26 may and 3 september 1998, 177 cases were reported, including 71 cases of intestinal amoebiasis and 106 probable cases of liver abscess. the nicobarese people have attested to the medicinal properties found in glochidion calocarpum, a plant common to india, saying that its bark and seed are most effective in curing abdominal disorders associated with amoebiasis. society and culture an outbreak of amoebic dysentery occurs in diana gabaldon's novel a breath of snow and ashes.