PMID- 35959080
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220813
IS  - 2376-0605 (Electronic)
IS  - 2376-0605 (Linking)
VI  - 8
IP  - 4
DP  - 2022 Jul-Aug
TI  - Emphysematous Cystitis and Urinary Retention in a Male Patient With Diabetes 
      Mellitus Type 2 Treated With Empagliflozin.
PG  - 163-165
LID - 10.1016/j.aace.2022.04.002 [doi]
AB  - OBJECTIVE: Emphysematous cystitis (EC) is a rare urinary tract infection (UTI) 
      typically associated with severe diabetes in older women. We present a unique 
      case of this gas-forming infection in a man with type 2 diabetes mellitus (T2DM) 
      treated with empagliflozin. To the best of our knowledge, this is the first case 
      report of EC associated with the use of a sodium-glucose cotransporter 2 
      inhibitor (SGLT2i). CASE REPORT: A 62-year-old man with T2DM treated with an 
      SGLT2i developed EC. His moderately controlled T2DM was treated for over 20 years 
      with metformin, saxagliptin/metformin, and pioglitazone to which empagliflozin 
      was added due to his consistently elevated hemoglobin A1c level, slightly reduced 
      estimated glomerular filtration rate, and proteinuria. Four months after 
      initiation of the SGLT2i, he reported lower urinary tract symptoms and was found 
      to have EC radiographically. His urine cultures were positive for Klebsiella 
      pneumonia and was found to have asymptomatic urinary retention. He was treated 
      conservatively, and his outcome was favorable. DISCUSSION: EC is commonly seen in 
      patients with diabetes mellitus, and symptoms range from asymptomatic to severe 
      sepsis. Most urine cultures grow Escherichia coli and K. pneumonia. The 
      association of increased UTIs in susceptible patients with T2DM with the use of 
      SGLT2i is yet to be determined. Most cases of EC are diagnosed radiographically 
      and treated conservatively, although some cases require surgical intervention. 
      CONCLUSION: Initially, our patient was considered a good candidate for treatment 
      with an SGLT2i. The subsequent development of EC precluded its further use. The 
      role of SGLT2i in patients with T2DM susceptible to UTI is controversial.
CI  - (c) 2022 AACE. Published by Elsevier Inc.
FAU - Brock, Gina M
AU  - Brock GM
AD  - Idaho College of Osteopathic Medicine, Meridian, Idaho.
FAU - Lane, Sarah M
AU  - Lane SM
AD  - Idaho Diabetes-Endocrine Associates, Boise, Idaho.
FAU - Roosevelt, Theodore S
AU  - Roosevelt TS
AD  - Idaho Diabetes-Endocrine Associates, Boise, Idaho.
LA  - eng
PT  - Case Reports
DEP - 20220408
PL  - United States
TA  - AACE Clin Case Rep
JT  - AACE clinical case reports
JID - 101670593
PMC - PMC9363503
OTO - NOTNLM
OT  - CT, computed tomography
OT  - EC, emphysematous cystitis
OT  - ER, extended-release
OT  - FG, Fournier gangrene
OT  - GU, genitourinary
OT  - HbA1c, hemoglobin A1c
OT  - LUT, lower urinary tract
OT  - PVR, postvoid residual
OT  - SGLT2 inhibitors
OT  - SGLT2i, sodium-glucose cotransporter 2 inhibitor
OT  - T2DM, type 2 diabetes mellitus
OT  - US, ultrasound
OT  - UTI, urinary tract infection
OT  - diabetes mellitus type 2
OT  - empagliflozin
OT  - emphysematous cystitis
OT  - urinary tract infection
EDAT- 2022/08/13 06:00
MHDA- 2022/08/13 06:01
PMCR- 2022/04/08
CRDT- 2022/08/12 03:07
PHST- 2021/09/30 00:00 [received]
PHST- 2022/03/31 00:00 [revised]
PHST- 2022/04/04 00:00 [accepted]
PHST- 2022/08/12 03:07 [entrez]
PHST- 2022/08/13 06:00 [pubmed]
PHST- 2022/08/13 06:01 [medline]
PHST- 2022/04/08 00:00 [pmc-release]
AID - S2376-0605(22)00025-6 [pii]
AID - 10.1016/j.aace.2022.04.002 [doi]
PST - epublish
SO  - AACE Clin Case Rep. 2022 Apr 8;8(4):163-165. doi: 10.1016/j.aace.2022.04.002. 
      eCollection 2022 Jul-Aug.