PDF(Pubmed)
Abstract：
We present the case of a 51-year-old male with known congestive heart failure and acute myocarditis who presented to the emergency department (ED) with swollen testicles and urinary symptoms two weeks after the initiation of sodium glucose cotransporter 2 (SGLT2) inhibitor treatment. Abdominal and pelvic computed tomography (CT) scan was consistent with the diagnosis of Fournier\'s gangrene (FG). Intravenous antibiotics were administered and surgical exploratory intervention and excision of necrotic tissue were performed, stopping the evolution of necrotizing fasciitis. FG, a reported adverse event, may rarely occur when SGLT2 inhibitors are administered in patients with diabetes. To our knowledge, there have been no reported cases of FG in Romania since SLGT2 inhibitors were approved. The distinguishing feature of this case is that the patient was not diabetic, which emphasizes that patients without diabetes who are treated for heart failure with SGLT2 inhibitors may also be at risk of developing genitourinary infections. The association of predisposing factors may have contributed to the development of FG in this case and even though the benefits of SGLT2 inhibitors outweigh the risks, serious adverse events need to be voluntarily reported in order to intervene promptly, verify the relationship, and minimize the risk of bias.
摘要：
我们介绍了一名51岁的男性，患有已知的充血性心力衰竭和急性心肌炎，他在开始钠葡萄糖协同转运蛋白2（SGLT2）抑制剂治疗后两周出现睾丸肿胀和泌尿症状的急诊科（ED）。腹部和盆腔计算机断层扫描（CT）扫描与Fournier坏疽（FG）的诊断一致。静脉给予抗生素，并进行手术探查干预和坏死组织切除，阻止坏死性筋膜炎的演变。FG,报告的不良事件，在糖尿病患者中施用SGLT2抑制剂时，可能很少发生。据我们所知,自从SLGT2抑制剂获得批准以来,罗马尼亚没有FG病例的报道.这种情况的显着特征是患者不是糖尿病，该研究强调,接受SGLT2抑制剂治疗心力衰竭的非糖尿病患者也可能存在发生泌尿生殖系统感染的风险.在这种情况下，诱发因素的关联可能有助于FG的发展，即使SGLT2抑制剂的益处大于风险，严重不良事件需要自愿报告，以便及时干预，验证关系，并将偏见的风险降至最低。
