{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T17:11:03Z","timestamp":1781111463598,"version":"3.54.1"},"reference-count":16,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>Sodium-glucose cotransporter 2 (SGLT2) inhibitors, which are used for treatment of type 2 diabetes, are associated with risk of urogenital infections. FDA issued a black box warning about multiple case reports of Fournier\u2019s gangrene (FG) observed in patients taking SGLT2 inhibitors. FG is a type of necrotising fasciitis that occurs in the anogenital area. We report a case of a 71-year-old woman with type 2 diabetes on dapagliflozin, presenting with foul-smelling discharge and a large abscess in the perianal area. Her risk factors for FG included her advanced age, obesity, diabetes and trauma to the site. During her stay, dapagliflozin was discontinued and she received procedural debridement, wound care and broad-spectrum intravenous antibiotics. Due to possible association between FG and SGLT2 inhibitors, patients presenting with signs and symptoms of FG who are taking SGLT2 inhibitors should be examined for infection in the urogenital area and treated promptly.<\/jats:p>","DOI":"10.1136\/bcr-2020-237784","type":"journal-article","created":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T21:23:47Z","timestamp":1612214627000},"page":"e237784","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Fournier\u2019s gangrene with dapagliflozin in a rural hospital: a case report"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3339-6203","authenticated-orcid":false,"given":"Ali","family":"Elbeddini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasamin","family":"Tayefehchamani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Davey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodi","family":"Gallinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naushin","family":"Hooda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Aly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Erickson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,2,1]]},"reference":[{"key":"2021020110051551000_14.2.e237784.1","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1056\/NEJMoa1504720","article-title":"Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes","volume":"373","author":"Zinman","year":"2015","journal-title":"N Engl J Med Overseas Ed"},{"key":"2021020110051551000_14.2.e237784.2"},{"key":"2021020110051551000_14.2.e237784.3","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1056\/NEJMoa1812389","article-title":"Dapagliflozin and cardiovascular outcomes in type 2 diabetes","volume":"380","author":"Wiviott","year":"2019","journal-title":"N Engl J Med Overseas Ed"},{"key":"2021020110051551000_14.2.e237784.4","doi-asserted-by":"publisher","DOI":"10.7326\/M19-0085"},{"key":"2021020110051551000_14.2.e237784.5","unstructured":"U.S. Food and Drug Administration . FDA warns about rare occurrences of a serious infection of the genital area with SGLT2 inhibitors for diabetes, 2018. Available: https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-warns-about-rare-occurrences-serious-infection-genital-area-sglt2-inhibitors-diabetes"},{"key":"2021020110051551000_14.2.e237784.6","unstructured":"US Food and Drug Administration . FDA removes boxed warning for type 2 diabetes medicine canagliflozin, 2020. Available: https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-removes-boxed-warning-about-risk-leg-and-foot-amputations-diabetes-medicine-canagliflozin [Accessed 26 Oct 2020]."},{"key":"2021020110051551000_14.2.e237784.7","doi-asserted-by":"publisher","DOI":"10.4081\/aiua.2016.3.157"},{"key":"2021020110051551000_14.2.e237784.8","doi-asserted-by":"crossref","first-page":"e920115","DOI":"10.12659\/AJCR.920115","article-title":"A case of Fournier's gangrene in a patient taking canagliflozin for the treatment of type II diabetes mellitus","volume":"21","author":"Elbeddini","year":"2020","journal-title":"Am J Case Rep"},{"key":"2021020110051551000_14.2.e237784.9","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1111\/dme.13508","article-title":"Fournier's gangrene in a man on empagliflozin for treatment of type 2 diabetes","volume":"34","author":"Kumar","year":"2017","journal-title":"Diabet Med"},{"key":"2021020110051551000_14.2.e237784.10","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1111\/1753-0407.12896","article-title":"Fournier's gangrene in a patient on dapagliflozin treatment for type 2 diabetes","volume":"11","author":"Onder","year":"2019","journal-title":"J Diabetes"},{"key":"2021020110051551000_14.2.e237784.11","doi-asserted-by":"crossref","first-page":"64","DOI":"10.25179\/tjem.2018-63449","article-title":"Case report: fixed drug eruption caused by dapagliflozin","volume":"23","author":"Sunumu","year":"2019","journal-title":"Case Rep Turk J Endocrinol Metab"},{"key":"2021020110051551000_14.2.e237784.12","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2005.042069"},{"key":"2021020110051551000_14.2.e237784.13","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.1093\/cid\/ciu296","article-title":"Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America","volume":"59","author":"Stevens","year":"2014","journal-title":"Clin Infect Dis [Internet]"},{"key":"2021020110051551000_14.2.e237784.14","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiw229"},{"key":"2021020110051551000_14.2.e237784.15","first-page":"1","article-title":"Fournier\u2019s gangrene in a patient with type 2 diabetes mellitus treated with empagliflozin: a case report","volume":"6","author":"Nagano","year":"2019","journal-title":"Drug Saf"},{"key":"2021020110051551000_14.2.e237784.16","article-title":"Fournier's gangrene under sodium-glucose cotransporter 2 inhibitor therapy as a life-threatening adverse event: a case report and review of the literature","volume":"11","author":"Rodler","year":"2019","journal-title":"Cureus"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-237784","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T21:23:54Z","timestamp":1612214634000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-237784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":16,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,1]]},"published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1136\/bcr-2020-237784"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-237784","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2]]}}}