Clinical Pharmacy Department, Winchester District Memorial Hospital, Winchester, Ontario, Canada
Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
BMJ Case Rep. 2021 Feb 1;14(2):e237784. doi: 10.1136/bcr-2020-237784.
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.
钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂被用于治疗 2 型糖尿病，与泌尿生殖系统感染的风险相关。美国食品药品监督管理局（FDA）发布了一则黑框警告，称在使用 SGLT2 抑制剂的患者中观察到多种福尼尔坏疽（FG）的病例报告。FG 是一种发生在会阴部的坏死性筋膜炎。我们报告了一例 71 岁的女性，患有 2 型糖尿病，正在服用达格列净，表现为有臭味的分泌物和肛周区域的一个大脓肿。她 FG 的危险因素包括高龄、肥胖、糖尿病和该部位的创伤。在她住院期间，停用了达格列净，她接受了清创术、伤口护理和广谱静脉内抗生素治疗。由于 FG 与 SGLT2 抑制剂之间可能存在关联，因此对于出现 FG 迹象和症状且正在服用 SGLT2 抑制剂的患者，应检查泌尿生殖系统区域是否有感染，并及时进行治疗。
