Polymyxin B-Induced Diffuse Cutaneous Hyperpigmentation
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 2
Abstract
Polymyxin B is a polypeptide-antibiotic, primarily used for resistant Gram-negative infections, first obtained from bacterium Bacillus polymyxa in the late 1940s. Antibiotic spectrum are restricted to mainly gram negative bacterias like Enterobacter, E. coli, Klebsiella, Salmonella, Pasteurella, Bordetella, Shigella; and particularly organisms like Pseudomonas aeruginosa and Acinetobacter baumannii, which are extremely potent to acquire antibiotic resistance. Side effects include neurotoxicity and acute renal tubular necrosis. Here, we present a rare case of skin hyper-pigmentation in a 65-year-old elderly male of Indian origin, diagnosed as a case of MultiDrug Resistant (MDR) Klebsiella pneumonia, treated with intravenous antibiotics. The manifestations were observed after 4 days of Polymyxin B therapy initiation. All other concomitant drugs, infections, or immunologic disorders that, could have caused this symptom, were carefully excluded. An objective causality assessment reveals that, the cutaneous hyperpigmentation was possibly associated with Polymyxin B therapy, though further studies may be needed to explain the underlying mechanism.
Authors and Affiliations
Sandeep Lahiry, Shouvik Choudhury, Ayan Mukherjee, Prajesh Kiran Bhunya, Moumita Bala
Challenges, Issues and Warnings from CLSI and EUCAST Working Group on Polymyxin Susceptibility Testing
Letter to Editor
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