2019 Volume 62 Issue 7 Pages 389-397
The patient was a 74-year-old woman with type 2 diabetes that had been diagnosed when she was 56 years of age. In early May, she visited a dermatologist due to pain in the left gluteal region, but the antibiotics that she was prescribed did not alleviate this symptom. She had been taking dapagliflozin since mid-October of the previous year. In mid-May, she was discovered after a fall and was transferred to our hospital. Her body temperature was 38.6 °C. Severe inflammation was evident from redness in the region of the left side of the anus and perineum, a white blood cell count of 17200 /μL, and a C-reactive protein level of 29.7 mg/mL. A finding of gas within the subcutaneous fat on the left perineum on computed tomography led to a diagnosis of Fournier's gangrene (FG), and the patient was subsequently transferred to the Department of Dermatology at Oita University. Emergency incision and debridement with multidisciplinary therapy saved her life. In August 2018, the US Food and Drug Administration issued safety information about an increased risk of FG in patients on SGLT2 inhibitors (SGLT2i). We encountered a patient who developed FG while on an SGLT2i and report this case as a warning about the use of SGLT2i.
