肺气肿性膀胱炎(EC)是一种罕见的尿路感染(UTI),通常与老年妇女的严重糖尿病有关。我们介绍了在接受依帕列净治疗的2型糖尿病(T2DM)男性中这种气体形成感染的独特病例。据我们所知,这是第一例与使用钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)相关的EC报告.
■一名62岁的T2DM患者接受SGLT2i治疗后出现EC。他的中度控制的T2DM使用二甲双胍治疗超过20年,沙格列汀/二甲双胍,和吡格列酮,由于他的血红蛋白A1c水平持续升高,估计肾小球滤过率略有降低,和蛋白尿。SGLT2i启动四个月后,他报告了下尿路症状,并在影像学上发现了EC。他的尿液培养物对肺炎克雷伯菌呈阳性,并发现无症状的尿retention留。他被保守地对待,他的结果是有利的。
■EC常见于糖尿病患者,症状从无症状到严重败血症不等。大多数尿液培养物生长大肠杆菌和肺炎克雷伯菌。尚未确定T2DM易感患者中UTI增加与SGLT2i使用的关联。大多数EC病例经影像学诊断和保守治疗,尽管有些病例需要手术干预。
■最初,我们的患者被认为是SGLT2i治疗的良好候选者.EC的后续发展阻止了其进一步使用。SGLT2i在对UTI易感的T2DM患者中的作用存在争议。
UNASSIGNED: Emphysematous cystitis (EC) is a rare urinary tract infection (UTI) typically associated with severe diabetes in older women. We present a unique case of this gas-forming infection in a man with type 2 diabetes mellitus (T2DM) treated with empagliflozin. To the best of our knowledge, this is the first case report of EC associated with the use of a sodium-glucose cotransporter 2 inhibitor (SGLT2i).
UNASSIGNED: A 62-year-old man with T2DM treated with an SGLT2i developed EC. His moderately controlled T2DM was treated for over 20 years with metformin, saxagliptin/metformin, and pioglitazone to which empagliflozin was added due to his consistently elevated hemoglobin A1c level, slightly reduced estimated glomerular filtration rate, and proteinuria. Four months after initiation of the SGLT2i, he reported lower urinary tract symptoms and was found to have EC radiographically. His urine cultures were positive for Klebsiella pneumonia and was found to have asymptomatic urinary retention. He was treated conservatively, and his outcome was favorable.
UNASSIGNED: EC is commonly seen in patients with diabetes mellitus, and symptoms range from asymptomatic to severe sepsis. Most urine cultures grow Escherichia coli and K. pneumonia. The association of increased UTIs in susceptible patients with T2DM with the use of SGLT2i is yet to be determined. Most cases of EC are diagnosed radiographically and treated conservatively, although some cases require surgical intervention.
UNASSIGNED: Initially, our patient was considered a good candidate for treatment with an SGLT2i. The subsequent development of EC precluded its further use. The role of SGLT2i in patients with T2DM susceptible to UTI is controversial.