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Fournier’s Gangrene in an HIV-Positive Patient on Empagliflozin for the Treatment of Diabetes Mellitus
Fournier's gangrene is a severe polymicrobial infection that results in necrosis of the perineal and genital fasciae with rapid progression. This case report describes a 55-year-old male with a past medical history of HIV, type 2 diabetes, and hypertension who was diagnosed with Fournier's...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9255910/ https://www.ncbi.nlm.nih.gov/pubmed/35812611 http://dx.doi.org/10.7759/cureus.26083 |
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author | Khokhar, Farzam Hernandez, Carina Mahapatra, Rahul |
author_facet | Khokhar, Farzam Hernandez, Carina Mahapatra, Rahul |
author_sort | Khokhar, Farzam |
collection | PubMed |
description | Fournier's gangrene is a severe polymicrobial infection that results in necrosis of the perineal and genital fasciae with rapid progression. This case report describes a 55-year-old male with a past medical history of HIV, type 2 diabetes, and hypertension who was diagnosed with Fournier's gangrene after the administration of empagliflozin (Jardiance). The patient presented with a worsening ulcer of the right groin and was diagnosed with Fournier’s gangrene based on clinical and radiographic findings. He underwent surgical debridement of the wound. The patient was treated with empiric vancomycin, piperacillin-tazobactam, and clindamycin. Wound cultures grew Streptococcus anginosus and Staphylococcus epidermidis. His antibiotic regimen was simplified to ampicillin-sulbactam. The patient required reconstructive surgery for wound closure after debridement. He received an additional 18 days of augmentin therapy with the resolution of the infectious process. At the time of Fournier’s gangrene onset, the patient's last HbA1C level was 8.2%, despite treatment with glipizide and empagliflozin. This case suggests an association between empagliflozin and Fournier’s gangrene in the setting of active HIV infection. |
format | Online Article Text |
id | pubmed-9255910 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-92559102022-07-07 Fournier’s Gangrene in an HIV-Positive Patient on Empagliflozin for the Treatment of Diabetes Mellitus Khokhar, Farzam Hernandez, Carina Mahapatra, Rahul Cureus Internal Medicine Fournier's gangrene is a severe polymicrobial infection that results in necrosis of the perineal and genital fasciae with rapid progression. This case report describes a 55-year-old male with a past medical history of HIV, type 2 diabetes, and hypertension who was diagnosed with Fournier's gangrene after the administration of empagliflozin (Jardiance). The patient presented with a worsening ulcer of the right groin and was diagnosed with Fournier’s gangrene based on clinical and radiographic findings. He underwent surgical debridement of the wound. The patient was treated with empiric vancomycin, piperacillin-tazobactam, and clindamycin. Wound cultures grew Streptococcus anginosus and Staphylococcus epidermidis. His antibiotic regimen was simplified to ampicillin-sulbactam. The patient required reconstructive surgery for wound closure after debridement. He received an additional 18 days of augmentin therapy with the resolution of the infectious process. At the time of Fournier’s gangrene onset, the patient's last HbA1C level was 8.2%, despite treatment with glipizide and empagliflozin. This case suggests an association between empagliflozin and Fournier’s gangrene in the setting of active HIV infection. Cureus 2022-06-19 /pmc/articles/PMC9255910/ /pubmed/35812611 http://dx.doi.org/10.7759/cureus.26083 Text en Copyright © 2022, Khokhar et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Internal Medicine Khokhar, Farzam Hernandez, Carina Mahapatra, Rahul Fournier’s Gangrene in an HIV-Positive Patient on Empagliflozin for the Treatment of Diabetes Mellitus |
title | Fournier’s Gangrene in an HIV-Positive Patient on Empagliflozin for the Treatment of Diabetes Mellitus |
title_full | Fournier’s Gangrene in an HIV-Positive Patient on Empagliflozin for the Treatment of Diabetes Mellitus |
title_fullStr | Fournier’s Gangrene in an HIV-Positive Patient on Empagliflozin for the Treatment of Diabetes Mellitus |
title_full_unstemmed | Fournier’s Gangrene in an HIV-Positive Patient on Empagliflozin for the Treatment of Diabetes Mellitus |
title_short | Fournier’s Gangrene in an HIV-Positive Patient on Empagliflozin for the Treatment of Diabetes Mellitus |
title_sort | fournier’s gangrene in an hiv-positive patient on empagliflozin for the treatment of diabetes mellitus |
topic | Internal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9255910/ https://www.ncbi.nlm.nih.gov/pubmed/35812611 http://dx.doi.org/10.7759/cureus.26083 |
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