title: Polymyxin B-Induced Diffuse Cutaneous Hyperpigmentation.
abstract: Polymyxin B is a polypeptide-antibiotic, primarily used for resistant Gram-negative infections, first obtained from bacteriumBacillus polymyxain the late 1940s. Antibiotic spectrum are restricted to mainly gram negative bacterias likeEnterobacter, E. coli, Klebsiella, Salmonella, Pasteurella, Bordetella, Shigella; and particularly organisms likePseudomonas aeruginosaandAcinetobacter 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 Multi-Drug 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.affiliation: Post Graduate Trainee, Department of Pharmacology, Institute of Post Graduate Medical Education and Research , Kolkata, West Bengal, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Lahiry
authors.affiliation: Post Graduate Trainee, Department of Pharmacology, Institute of Post Graduate Medical Education and Research , Kolkata, West Bengal, India .
authors.forename: Shouvik
authors.initials: S
authors.lastname: Choudhury
authors.affiliation: Post Graduate Trainee, Department of Pharmacology, Institute of Post Graduate Medical Education and Research , Kolkata, West Bengal, India .
authors.forename: Ayan
authors.initials: A
authors.lastname: Mukherjee
authors.affiliation: Post Graduate Trainee, Department of Pharmacology, Institute of Post Graduate Medical Education and Research , Kolkata, West Bengal, India .
authors.forename: Prajesh Kiran
authors.initials: PK
authors.lastname: Bhunya
authors.affiliation: Post Graduate Trainee, Department of Pharmacology, Institute of Post Graduate Medical Education and Research , Kolkata, West Bengal, India .
authors.forename: Moumita
authors.initials: M
authors.lastname: Bala
keywords: Drug reaction; Klebsiella; Multidrug resistant