Abstract
BackgroundPolymyxin B (PMB), which is regarded as the ultimate antibacterial treatment against some intractable gram-negative bacteria with its outstanding anti-bacterial activities, inflicts several adverse effects on patients. However, skin hyperpigmentaion (SH) induced by PMB is very rare. Here, we report a case of polymyxin B-induced skin hyperpigmentation (PMB-iSH) in a 21-year-old female. To the best of our knowledge, this is the first case of PMB-iSH in China.Case presentationA 21-year-old female patient with sepsis received the administration of PMB by intravenous injection for the treatment of multi-drug resistant Klebsiella pneumoniae (MDR-KP) infection. She later suffered from a rare adverse drug reaction (ADR), namely PMB-iSH, after 5-day PMB administration during her treatment. There were multiple red rashes spread on the whole body skin at first. With the rashes fading away, SH with dark round spots appeared, associated with no pain or pruritus. The skin of the head and neck was darkened evidently, and dark brown spots were spread on the skin of trunk and limbs. About a month after her admission, urged by the relatives, the patient was transferred back to the local hospital for further treatment in the end, and her skin color didn’t recover to the previous state at that time.ConclusionBoth our case and the literature review highlight that PMB can give rise to SH indeed. Clinicians and pharmacists should attach great importance to this rare pigmentary disorder and further investigation is warranted.
Highlights
Polymyxin B (PMB), which is regarded as the ultimate antibacterial treatment against some intractable gram-negative bacteria with its outstanding anti-bacterial activities, inflicts several adverse effects on patients
Both our case and the literature review highlight that PMB can give rise to skin hyperpigmentaion (SH)
We discuss a patient with sepsis who was treated by intravenous PMB and suffered from a rare adverse drug reaction (ADR) afterward, namely polymyxin B-induced skin hyperpigmentation (PMB-iSH), on the basis of a literature review of its epidemiology, pathological mechanism, treatment options and prognosis
Summary
Polymyxin B (PMB), which is regarded as the ultimate antibacterial treatment against some intractable gram-negative bacteria with its outstanding anti-bacterial activities, inflicts several adverse effects on patients. Drug-induced skin hyperpigmentation (DiSH) is an important part of SH, accounting for 10 to 20% of all acquired SH cases [1]. We discuss a patient with sepsis who was treated by intravenous PMB and suffered from a rare adverse drug reaction (ADR) afterward, namely polymyxin B-induced skin hyperpigmentation (PMB-iSH), on the basis of a literature review of its epidemiology, pathological mechanism, treatment options and prognosis.
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