Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Khokhar, Farzam, Hernandez, Carina, Mahapatra, Rahul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
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
_version_ 1784741013221277696
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
work_keys_str_mv AT khokharfarzam fourniersgangreneinanhivpositivepatientonempagliflozinforthetreatmentofdiabetesmellitus
AT hernandezcarina fourniersgangreneinanhivpositivepatientonempagliflozinforthetreatmentofdiabetesmellitus
AT mahapatrarahul fourniersgangreneinanhivpositivepatientonempagliflozinforthetreatmentofdiabetesmellitus