Unique Presentation of Asymptomatic Bacteriuria, Vertebral Osteomyelitis, and Iliopsoas Abscess Due to Klebsiella pneumonia in a 73-Year-Old Man with Type 2 Diabetes Mellitus on Empagliflozin
Abstract
Patient: Male, 73-year-old Final Diagnosis: Asymptomatic bacteriuria • vertebral osteomyelitis • iliopsoas abscess Symptoms: Back pain Clinical Procedure: — Specialty: Endocrinology and Metabolic • Infectious Diseases • General and Internal Medicine Objective: Unusual clinical course Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2), such as empagliflozin, used to treat type 2 diabetes mellitus (DM), can increase the risk of infections, including urinary tract infections and osteomyelitis, especially in elderly patients. The use of SGLT2 inhibitors has been increasing dramatically in the last few years. Therefore, their adverse effects and complications have also been increasing. Herein, this report describes a 73-year-old man with type 2 DM treated with empagliflozin presenting with asymptomatic bacteriuria, vertebral osteomyelitis and iliopsoas abscess due to Klebsiella pneumoniae. Case Report: We report a 73-year-old man with DM on empagliflozin who presented with back pain of 1-month duration with elevated inflammatory markers. On lumbar spine magnetic resonance imaging (MRI), he was found to have lumbar vertebral osteomyelitis and left iliopsoas abscess. His symptoms were improved with abscess drainage and antimicrobial therapy. The source of infection was most likely asymptomatic bacteriuria, which may have been secondary to empagliflozin treatment, as evidenced by the urine, the blood, the bone and abscess cultures revealing growth of Klebsiella…
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