TY - JOUR
T1 - Sodium-glucose cotransporter 2 inhibitor-associated severe epididymo-orchitis
AU - Mishra, Rahul
AU - Elshimy, Ghada
AU - Kannan, Lakshmi
AU - Raj, Rishi
N1 - Publisher Copyright:
© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - A man in his late 50s, with uncontrolled type 2 diabetes mellitus (T2DM) and morbid obesity, presented to the hospital with complicated epididymo-orchitis. The onset of symptoms (scrotal pain, erythema and swelling) occurred after the use of empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, for 2 months. His baseline antidiabetic medications were insulin, glipizide and metformin. Initially, he had failed treatment of epididymo-orchitis with oral levofloxacin for 3 weeks, followed by 2 weeks of doxycycline therapy. At the presentation to the hospital, an ultrasound of the scrotum revealed scrotal and right testicular abscess. The patient underwent right inguinal orchiectomy. Postoperatively, pus culture was positive for Enterococcus faecalis and Candida glabrata, and hence, he was treated with oral antibiotics including high-dose antifungal medications. Adequate wound care and regular follow-up demonstrated resolution of infection. This case highlights the risk of severe urogenital infection associated with the use of SGLT2 inhibitors in the setting of uncontrolled T2DM.
AB - A man in his late 50s, with uncontrolled type 2 diabetes mellitus (T2DM) and morbid obesity, presented to the hospital with complicated epididymo-orchitis. The onset of symptoms (scrotal pain, erythema and swelling) occurred after the use of empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, for 2 months. His baseline antidiabetic medications were insulin, glipizide and metformin. Initially, he had failed treatment of epididymo-orchitis with oral levofloxacin for 3 weeks, followed by 2 weeks of doxycycline therapy. At the presentation to the hospital, an ultrasound of the scrotum revealed scrotal and right testicular abscess. The patient underwent right inguinal orchiectomy. Postoperatively, pus culture was positive for Enterococcus faecalis and Candida glabrata, and hence, he was treated with oral antibiotics including high-dose antifungal medications. Adequate wound care and regular follow-up demonstrated resolution of infection. This case highlights the risk of severe urogenital infection associated with the use of SGLT2 inhibitors in the setting of uncontrolled T2DM.
KW - Diabetes
KW - Endocrine system
KW - Infections
KW - Urinary and genital tract disorders
KW - Urinary tract infections
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U2 - 10.1136/bcr-2022-250942
DO - 10.1136/bcr-2022-250942
M3 - Article
C2 - 35817490
AN - SCOPUS:85133776517
SN - 1757-790X
VL - 15
JO - BMJ Case Reports
JF - BMJ Case Reports
IS - 7
M1 - e250942
ER -