SGLT2 Inhibitors and Complicated Urinary Tract Infections: A Rare Case of Emphysematous Pyelonephritis and Subsequent Recurrence Associated With Dapagliflozin Use

Harveen Kaur; Shaylika Chauhan; Manajyoti Yadav

doi:10.1002/ccr3.71320

SGLT2 Inhibitors and Complicated Urinary Tract Infections: A Rare Case of Emphysematous Pyelonephritis and Subsequent Recurrence Associated With Dapagliflozin Use

Clin Case Rep. 2025 Oct 16;13(10):e71320. doi: 10.1002/ccr3.71320. eCollection 2025 Oct.

Authors

Harveen Kaur^{1

2}, Shaylika Chauhan³, Manajyoti Yadav²

Affiliations

¹ Department of Internal Medicine University of Chicago Medical Center Chicago Illinois USA.
² Department of Internal Medicine University of Illinois College of Medicine at Peoria Peoria Illinois USA.
³ Department of Internal Medicine Geisinger Health System Wilkes-Barre Pennsylvania USA.

Abstract

Clinicians should exercise caution when prescribing dapagliflozin, a sodium-glucose co-transporter-2 (SGLT2) inhibitor, as it may increase the risk of severe and complicated urinary tract infections (UTIs). This case illustrates how a patient with no prior UTI history developed emphysematous pyelonephritis, a severe life-threatening renal infection, while on dapagliflozin. The patient subsequently developed recurrent pyelonephritis upon resuming the medication, further underscoring the potential association between dapagliflozin use and complicated UTIs.

Keywords: dapagliflozin; emphysematous pyelonephritis; recurrent pyelonephritis; sodium‐glucose cotransporter‐2 inhibitors; urinary tract infections.