Candida parapsilosis Fungemia in a Patient With Spinal Cord Injury on Sodium-Glucose Cotransporter-2 Inhibitor...

Individuals with spinal cord injury (SCI) and neurogenic bladder often rely on catheterization programs, which increase the risk of urinary tract infections (UTIs). Sodium-glucose cotransporter-2 inhibitors (SGLT2i), widely used in the management of diabetes mellitus (DM), chronic kidney disease (CKD), and congestive heart failure (CHF), promote urinary glucose excretion, potentially fostering an environment favorable to bacterial and fungal growth. This case describes a 53-year-old man with long-standing traumatic cervical SCI and a suprapubic catheter who presented with sepsis secondary to Candida parapsilosis fungemia, in the context of SGLT2i use for DM management. This report suggests that the combination of SGLT2i therapy and chronic catheterization may increase the risk of urinary tract and invasive fungal infections. While current evidence is lacking, further investigation is warranted, and clinicians should exercise caution when prescribing SGLT2i in patients with SCI and bladder catheter use.