BACKGROUNDThe increased incidence of pyogenic liver abscess caused by Klebsiella pneumoniae (K.pneumoniae) was reported in the recent literature. This study was conducted retrospectively to investigate the clinical characteristics and outcomes of these patients.

METHODSMicrobiological and medical databases of a medical center were searched from January 2000 to June 2003. Eighty-four patients with liver abscess caused by K.pneumoniae were analyzed.

RESULTSIn the 84 patients, 52 men and 32 women aged (58.2 +/- 13.3) years on average, 64.4% had concomitant diabetes mellitus and 23.8% had biliary disease. The most common clinical symptoms were fever (98.8%), chills (69.0%) and abdominal pain (58.3%). 85.7% of the 84 patients received catheter drainage for the abscess. The length of hospital stay was (17.4 +/- 8.7) days. The mortality rate was 7.1%. Older age and presence of biliary disease were associated with mortality.

CONCLUSIONSThe low mortality of our patients was probably related to the high proportion of patients who received catheter drainage. Older age and presence of biliary disease were associated with the mortality.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Klebsiella Infections ; complications ; Klebsiella pneumoniae ; Liver Abscess, Pyogenic ; etiology ; Male ; Middle Aged ; Retrospective Studies

Background: Acne vulgaris is a chronic inflammatory condition of the pilosebaceous unit. Isotretinoin is used to treat moderate to severe acne that is resistant to antibiotics and topical agents. However, it may cause alterations in lipids and liver enzymes. Methods: A total of 129 patients with acne vulgaris (moderate to severe facial acne) treated with isotretinoin were recruited between May 2020 and July 2021 from the dermatology clinics at Hospital Serdang and Hospital Kuala Lumpur. Of these, 120 patients with complete data of lipid panel (total cholesterol, low density lipoprotein cholesterol [LDL], triglycerides [TG], and high density lipoprotein cholesterol [HDL]) and hepatic panel (alanine transaminase [ALT] and aspartate transaminase [AST]) levels at baseline, and in three subsequent follow-up visits (i.e., one, three, and six months) were included in the analyses. Abnormalities were graded according to standard laboratory values and their severity according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE)grading system. Results: Of the 120 study participants, 83% were female and 37% were male between the ages of 15 and 36 years. We observed a significant increase in median values at baseline and at the six-month follow-up for total cholesterol (p<0.0001), triglycerides (p<0.0001), LDL (p<0.0001), ALT (p<0.0001), and AST (p<0.0001). We observed a significant correlation between body mass index and the HDL (r2 =- 0.26, p=0.01) and ALT (r2 =0.383, p=7.9x10-06) levels. Based on the CTCAE grading system, almost all study participants with abnormal results had grade 1 abnormalities. Only one patient had a grade 2 abnormality in ALT, which required treatment discontinuation. Conclusion Low dose isotretinoin therapy for acne vulgaris may cause mild and non-progressive elevation of LDL, total cholesterol, and liver transaminases which do not require treatment withdrawal in most cases.
Isotretinoin--therapeutic use ; Acne Vulgaris-therapy