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Query: UMLS:C0011849 (diabetes)
277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A whole-body gallium-67 (Ga-67) scan of a 61-y-old male with diabetes mellitus who suffered from endogenous Klebsiella endophthalmitis is reported. The scan revealed right orbital and lower abdominal lesions. Urinary analysis revealed pyuria. The causes of endogenous Klebsiella endophthalmitis and the usefulness of Ga-67 are discussed.
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PMID:Gallium-67 scanning in endogenous Klebsiella endophthalmitis with unknown primary focus. 1087 10

A 51 year-old man fitted with a dental prosthesis was hospitalized with buccal swelling, fever and chest pain. Laboratory data showed marked inflammatory changes, and chest radiography and CT scanning revealed small nodular shadows within the lung. A diagnosis of multiple lung abscesses secondary to a buccal abscess possibly caused by the prosthesis was made from needle aspiration biopsies of the lung nodules and of a buccal lesion. Klebsiella pneumoniae was isolated from these lesions and from a blood culture. The patient was successfully treated with antibiotics and by surgical drainage of the buccal abscess. It is important to note that the patient was immunodeficient at the time as a result of diabetes and alcohol intoxication.
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PMID:[A case of Klebsiella pneumoniae infection causing a buccal abscess complicated with multiple lung abscesses]. 1101 72

Pyogenic liver abscess due to Klebsiella pneumoniae is a rare clinical entity. It has emerged as an important infection complication in diabetics and its incidence in diabetics without intraabdominal or biliary tract infections is increasing. We present herein a case of multiple pyogenic liver abscesses due to K. pneumoniae in a diabetic patient and discuss clinical course, treatment and possible reasons for association between K. pneumoniae liver abscess and diabetes.
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PMID:Pyogenic liver abscesses due to Klebsiella pneumoniae in a diabetic patient. 1129 2

Urinary tract infections (UTIs) are the most common infections seen in the hospital setting, and the second most common infections seen in the general population. Due to women's anatomy, UTIs are especially problematic for them, and up to one-third of all women will experience a UTI at some point during their lifetimes. Appropriate treatment of a UTI requires accurate classification that includes infection site, complexity of the infection, and the likelihood of recurrence. The predominant pathogen in both complicated and uncomplicated UTI remains pathogenic Escherichia coli, although Klebsiella sp. and Proteus appear with increased frequency in complicated UTI. Most often, bacteria cause UTIs by ascending means through the urethra into the bladder. Bacteria must possess virulence factors to cause UTI. Host defense factors that predispose patients to UTI include urinary stasis, abnormal urinary tract anatomy, diabetes mellitus, debility, and aging. Estrogen-related issues and short urethras predispose women to UTI. Although urine culture, with >105 colony-forming units/mL (CFU/mL) in symptomatic patients, remains the diagnostic "gold standard," correlation of the patient's history and physical examination with urinalysis (including nitrite dipstick and leukocyte esterase test) results usually suffices to diagnose UTI. Three-day of antimicrobial treatment is recommended for simple cystitis. Acute pyelonephritis, an infection of the kidney parenchyma tissue, is treated with antibiotics for 7 to 14 days depending on the antimicrobial agent used and the severity of infection. In addition, patient classification determines the need for hospitalization or for urological imaging studies. Women with recurrent UTIs merit consideration for antimicrobial prophylaxis. Self-administered topical vaginal estradiol cream is an important adjunct in UTI prevention for postmenopausal women. Asymptomatic bacteruria only merits antimicrobial therapy in high-risk patients or those colonized with Proteus species.
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PMID:Urinary tract infections in women. 1144 91

In a case control study, we assessed the prevalence of bacterial urinary tract infections (UTI) and renal scarring in 155 consecutive type 1 (n=102) and type 2 (n=53) diabetic individuals and 128 healthy controls. Subjects who received antibiotics during the past 6 months, pregnant women and those with overt renal failure were excluded. In all subjects, urine culture and 99m Technetium (Tc) dimercapto-succinic acid renal scan was performed. UTI was diagnosed if two consecutive urine cultures grew the same organism with at least 10(5) colony forming unit (cfu)/ml in asymptomatic and at least 10(4) cfu/ml in symptomatic subjects, respectively. Renal scan was considered abnormal if focal or multiple tracer uptake defects and/or break in cortical outline were observed. The prevalence of UTI in diabetes mellitus was higher, when compared to that in controls (9% vs. 0.78%, P=0.005). Escherichia coli was the most commonly grown organism (64.3%), followed by Staphyloccocus aureus (21.4%) and Klebsiella pneumoniae (14.3%). Prevalence of renal scarring was higher in patients with diabetes (28/155, 18.0%), when compared to that of controls (7/128, 5.4%, P=0.002). Fifty percent of patients with diabetes and UTI had renal scarring. The prevalence in diabetics with no UTI was also higher, when compared to controls (14.8 vs. 5.5%, P<0.01). The prevalence of UTI as well as renal scarring was significantly higher in females, when compared to male diabetics. No significant difference in vascular events, hypertension, proteinuria, renal function tests and HbA1 was observed in patients with and without renal scar. Thus, patients with diabetes mellitus have 10- and 3-folds increased risk of UTI and renal scarring, respectively. The results could help prioritize protocols for management of UTI among patients with diabetes mellitus.
Diabetes Res Clin Pract 2001 Sep
PMID:Prevalence of urinary tract infection and renal scars in patients with diabetes mellitus. 1148 34

Septic metastatic endophthalmitis is a rare but serious disease. Endophthalmitis arising from Klebsiella pneumoniae liver abscess has been reported with diabetes mellitus as a major associated condition, but is rarely seen in patients without diabetes. A non-diabetic patient with liver abscess complained of right eye discomfort and floaters 3 days after admission. Both blood and liver aspirate cultured Klebsiella pneumoniae. The patient was treated initially with systemic and subconjunctival antibiotics followed by intravitreal antibiotics with successful visual salvation. Previous reports from the literature showed poor visual outcome despite treatment and delayed recognition was often the cause. Clinicians should be alert to endophthalmitis whenever a patient with Klebsiella pneumoniae liver abscess complains of ocular symptoms. Urgent ophthalmological assessment should be sought.
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PMID:Septic metastatic endophthalmitis complicating Klebsiella pneumoniae liver abscess in a non-diabetic Chinese man. 1159 Feb 74

Seven cases of psoas abscess caused by Klebsiella pneumoniae were observed at the National Cheng Kung University Hospital within a period of 4.5 years. These cases constituted 25% of a total 28 episodes of non-tuberculous psoas abscess, ranking second to those caused by Staphylococcus aureus (8 cases). Eight cases of psoas abscess caused by K. pneumoniae were identified from Medline, and 5 of which were reported from Taiwan. Of these 8 cases, 1 neonatal case was excluded, and the remaining 7 adult cases were combined with the 7 cases in this series for analysis. The mean age was 53.8 years, and diabetes mellitus was the most common underlying disease. Fever and pain on the flank and back area were the common findings. The interval between the onset of symptoms and diagnosis ranged from 1 to 60 days. The most common sites of concurrent infection were the urinary tract (6 cases; 43%) and bone (3 cases; 21%). All patients received percutaneous or surgical drainage in addition to antibiotic treatment. Gas formation was present in 5 of the 12 patients recorded, and 4 of them died during hospitalization. Only 1 patient had a metastatic infection with osteomyelitis of the left radius and right humerus; he had experienced 5 episodes of recurrent K. pneumoniae infections in different sites. We concluded that K. pneumoniae should be considered as an important endemic pathogen of psoas abscess in diabetics in Taiwan. The high mortality rate in the gas-forming cases should also be highlighted. Early recognition, empiric antimicrobial coverage for K. pneumoniae, and aggressive drainage or debridement are indicated in these patients.
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PMID:Klebsiella pneumoniae psoas abscess: predominance in diabetic patients and grave prognosis in gas-forming cases. 1160 12

Two patients with diabetes mellitus developed Klebsiella pneumoniae pyomyositis involving multiple muscles and other metastatic foci associated with bacteraemia. The cases are presented here, and the 22 cases of gram-negative pyomyositis reported previously in the literature are reviewed. As gram-positive cocci cause 99% of pyomyositis, it is postulated that the pathogenesis of pyomyositis may be associated with the ability of the bacteria to adhere to muscles by various cell surface adhesins that are not present in gram-negative bacilli. It is also postulated that a high serum glucose concentration may facilitate the growth and formation of the Klebsiella pneumoniae capsule, hence increasing its virulence and causing serious disseminated Klebsiella infections in diabetic patients.
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PMID:Two cases of pyomyositis caused by Klebsiella pneumoniae and review of the literature. 1168 39

Liver abscess is a potentially life-threatening disease. The clinical features of pyogenic liver abscess are variable and probably correlate with a variety of pathogenic microorganisms and underlying diseases that may be involved. The most common pathogen of liver abscess in Taiwan is Klebsiella pneumoniae. Diabetes mellitus and hepatobiliary calculus are major diseases associated with liver abscess. Haemophilus parainfluenzae is a commensal of the upper respiratory tract, but is an uncommon isolate in liver abscess. We describe a 44-year-old man with liver abscess caused by mixed H. parainfluenzae and Fusobacterium necrophorum infection. He received percutaneous liver abscess drainage and intravenous antibiotic therapy for 3 weeks and fully recovered. No recurrence occurred during the follow-up period of 4 months.
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PMID:Haemophilus parainfluenzae and Fusobacterium necrophorum liver abscess: a case report. 1195 Jan 24

In Taiwan, the incidence of pyogenic liver abscess caused by Klebsiella pneumoniae has been increasing over the past 2 decades. Although most of the patients have no concurrent biliary tract disease, diabetes mellitus is thought to be an important risk factor for the disease. The incidence of metastatic infections in K. pneumoniae liver abscess, such as endogenous endophthalmitis and other extrahepatic infections, is also higher than that in liver abscess caused by other microbes. Furthermore, the incidence of metastatic infections in K. pneumoniae liver abscess in Taiwan is higher than Western countries. The reasons why K. pneumoniae liver abscess is so common in Taiwan and why diabetes mellitus is a risk factor for the disease are not clear. In this study, blood isolates from 40 patients with K. pneumoniae liver abscess treated at the Taipei Veterans General Hospital from 1995 through 2000 were randomly selected for study. Pulsed-field gel electrophoresis, ribotyping, and serotyping were used for cluster analysis. A total of 15 strains were of serotype K1 and 25 strains were of a serotype other than K1. No major cluster or a closely related strain of K. pneumoniae was found. In conclusion, the results obtained from pulse-field gel electrophoresis and ribotyping of K. pneumoniae isolates do not suggest that liver abscess in Taiwan is primarily caused by a single genetically related strain.
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PMID:Klebsiella pneumoniae liver abscess in Taiwan is not caused by a clonal spread strain. 1209 40


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