Literature case analysis of Fournier gangrene caused by sodium-glucose cotransporter 2 inhibitors
10.3760/cma.j.cn114015-20240528-00376
- VernacularTitle:钠-葡萄糖共转运蛋白2抑制剂致富尼埃坏疽的文献病例分析
- Author:
Daixiao CANG
1
;
Ru'nan SUN
;
Xianghua QUAN
;
Xue YANG
;
Xiaomin XING
;
Jun ZHAO
Author Information
1. 青岛大学附属医院药学部，青岛 266003
- Publication Type:Journal Article
- Keywords:
Sodium-glucose cotransporter protein 2 inhibitors;
Fournier gangrene;
Perineal necrotizing fasciitis;
Dapagliflozin;
Empagliflozin;
Canagliflozin;
Adverse r
- From:
Adverse Drug Reactions Journal
2025;27(3):147-152
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the characteristics of Fournier gangrene (FG) induced by sodium-glucose cotransporter 2 inhibitors (SGLT2i), and provide reference for clinical safe drug use.Methods:CNKI, Wanfang Med Online, VIP, PubMed, Web of Science and other databases (up to January 2024) were retrieved and clinical data on patients with FG associated with the 5 kinds of SGLT2i currently used in clinical practice in China were collected and descriptively analyzed, including gender, age, comorbidities, concomitant medications, onset time and clinical manifestations of SGLT2i-related FG, laboratory and imaging examination results, treatment and outcomes, etc.Results:A total of 15 documents were included in the analysis, involving 15 patients, with 12 males and 3 females. The age of these patients ranged from 34 to 72 years, with 11 cases being over 50 years. Dapagliflozin was used in 7 cases, empagliflozin in 6 cases, canagliflozin in 2 cases, and no related reports on ertugliflozin and henagliflozin were collected. The main clinical manifestations of the 15 patients were redness, swelling, pain, abscess or purulent discharge in perineum, scrotum and perianal, etc. The time from application of SGLT2i to onset of FG ranged from 1 month to 6 years. Wound secretion bacterial culture was performed in 10 patients, and the results were all positive, including 9 cases of bacterial infection and 1 case of mixed infection of bacteria and fungi. All 13 patients who underwent imaging examinations had imaging manifestations related to FG. SGLT2i were discontinued in all patients. After treatments with broad-spectrum antibiotics and surgery, 14 cases were improved and 1 case was cured.Conclusions:SGLT2i has the risk of causing FG, which is more common in males. The clinical use of SGLT2i should be monitored closely. Secretion culture and imaging examination are helpful for the diagnosis of FG. The patient′s prognosis is good after discontinuation of medication, symptomatic treatment, and surgery.
