Fournier's gangrene with dapagliflozin in a rural hospital: a case report.

Authors :: Elbeddini A
Tayefehchamani Y
Davey M
Gallinger J
Hooda N
Aly A
Erickson D
Lee S
Source :: BMJ case reports [BMJ Case Rep] 2021 Feb 01; Vol. 14 (2). Date of Electronic Publication: 2021 Feb 01.
Publication Year :: 2021
Abstract: Sodium-glucose cotransporter 2 (SGLT2) inhibitors, which are used for treatment of type 2 diabetes, are associated with risk of urogenital infections. FDA issued a black box warning about multiple case reports of Fournier's gangrene (FG) observed in patients taking SGLT2 inhibitors. FG is a type of necrotising fasciitis that occurs in the anogenital area. We report a case of a 71-year-old woman with type 2 diabetes on dapagliflozin, presenting with foul-smelling discharge and a large abscess in the perianal area. Her risk factors for FG included her advanced age, obesity, diabetes and trauma to the site. During her stay, dapagliflozin was discontinued and she received procedural debridement, wound care and broad-spectrum intravenous antibiotics. Due to possible association between FG and SGLT2 inhibitors, patients presenting with signs and symptoms of FG who are taking SGLT2 inhibitors should be examined for infection in the urogenital area and treated promptly.<br />Competing Interests: Competing interests: None declared.<br /> (© BMJ Publishing Group Limited 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)