Candida glabrata Prostatitis: A Rare Case in a Patient With Type 2 Diabetes Mellitus on Dapagliflozin Treatment.

Abstract

We present a case of acute Candida glabrata prostatitis complicated by secondary candidemia in a 72-year-old man with poorly controlled Type 2 diabetes mellitus and benign prostatic hyperplasia, without classical healthcare-associated risk factors for invasive candidiasis. The patient presented with fever, urinary symptoms, and markedly elevated prostate-specific antigen. Urine and blood cultures confirmed disseminated C. glabrata infection. Despite a comprehensive diagnostic workup, no alternative source of candidemia was identified, supporting primary prostatic infection with secondary hematogenous dissemination. Among the identified predisposing factors was ongoing treatment with dapagliflozin, a sodium-glucose cotransporter 2 inhibitor (SGLT2 inhibitor). While SGLT2 inhibitor use is established as a risk factor for superficial mycotic genitourinary infections, invasive fungal complications remain poorly characterized. This case suggests that the SGLT2 inhibitor-induced glucosuria, in combination with structural urinary obstruction and poorly controlled diabetes, may contribute to invasive fungal infections and highlights the need for clinical vigilance in patients with multiple converging risk factors.