Fournier’s Gangrene in a Patient with Type 2 Diabetes Mellitus Treated with Empagliflozin: A Case Report

Abstract

Sodium-glucose cotransporter-2 (SGLT2) inhibitors have been reported as possibly associated with Fournier’s gangrene (FG). This case report describes a 34-year-old Japanese man who was diagnosed with FG after the administration of empagliflozin for type 2 diabetes mellitus (T2DM). He presented with pain and swelling in the perineum and groin 142 days after initiating empagliflozin. The clinical features, laboratory data, and computed tomographic findings were consistent with FG. Surgical drainage and debridement of necrotic tissues were performed immediately after admission to our hospital. The patient had no complications of diabetes before the onset of FG. Glycemic management was good at the time of FG onset. This case suggests a possible association between empagliflozin and FG. We report a case of FG in a patient during a period of good glycemic management following treatment with empagliflozin. We recommend further awareness of this relationship and suggest the need for additional research.

Fournier Gangrene in a Patient With Type 2 Diabetes Mellitus Treated With Dapagliflozin: A Case Report

“…Kumar et al [9] reported a 41-year-old male patient with T2DM with an HbA1c of 11.2% using empagliflozin, and Onder et al [10] reported a 64-year-old male patient with T2DM with an HbA1c of 7.4% using dapagliflozin. However, similar to our case, Nagano et al [11] reported a 34-year-old male patient with T2DM with an HbA1c of 6.5% at the time of FG onset who was on sitagliptin, glibenclamide, and empagliflozin therapy. The patient had no additional complications from DM besides FG [11].…”

“…However, similar to our case, Nagano et al [11] reported a 34-year-old male patient with T2DM with an HbA1c of 6.5% at the time of FG onset who was on sitagliptin, glibenclamide, and empagliflozin therapy. The patient had no additional complications from DM besides FG [11]. Thus, the risk for developing FG remains in spite of good glycemic management with SGLT2 inhibitors.…”

Empagliflozin Use and Fournier’s Gangrene: Case Report and Systematic Literature Review

“…Despite the late stage presentation and the limited resources, the management of this case was successful, although it required a long-time admission and it absorbed limited human and economic resources. This is not the first case reported as others have been documented in recent years, especially in industrialised countries [10][11][12][13]. However, we present here the first systematic review on this topic.…”