Epididymo-Orchitis Leading to Testicular Infarction: Revealing a Potentially Severe Complication of SGLT2 Inhibitors

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are not only used for managing type 2 diabetes mellitus (T2DM) but also have been shown to be effective in reducing major cardiovascular events and slowing chronic kidney disease progression. However, they cause glycosuria, which increases the risk for genitourinary (GU) infections. We report a patient with uncontrolled T2DM who developed epididymo-orchitis 6 weeks after starting empagliflozin, which progressed to testicular infarction. Although not well documented, SGLT2 inhibitors may increase the risk for epididymo-orchitis because infections may ascend from the urinary tract. This case highlights the importance of close observation to avoid serious events associated with SGLT2 inhibitors.