多粘菌素B致色素沉着2例

Hyperpigmentation induced by polymyxin B: report of 2 cases

2例男性肝移植术后患者(例1,46岁;例2,41岁),因肺炎克雷伯菌感染给予多粘菌素B75mg(首次剂量例1,175mg;例2,150mg)静脉滴注、2次/d,分别于用药第13、15天出现头颈部皮肤色素沉着,其他部位肤色未发生变化。例1因感染未控制继续用药,头颈部皮肤颜色继续加深,至用药第29天因多器官衰竭死亡时,头颈部皮肤呈深棕褐色。例2因病情好转于用药第31天停用多粘菌素B,停药时头颈部皮肤呈深棕褐色;停药后随访4个月,头颈部皮肤颜色明显转淡,但未完全恢复。

Two male patients(patient 1,46 years old;patient 2,41 years old),who had underwent liver transplantation,received polymyxin B 75 mg(patient 1 175 mg and patient 2 150 mg at the first dose)by IV infusion twice daily because of postoperative infection by Klebsiella pneumoniae.They developed hyperpigmentation on the skin of the head and neck without any change on the rest of the body respectively on day 13 and 15 of the medication.Patient 1 continued to use the drug due to uncontrolled infection.The skin color of the head and neck continued to deepen and then appeared to be dark brown when the patient died of multiple organ failure on day 29 of the medication.Patient 2 stopped using polymyxin B because of the improvement of the condition on day 31 of the medication when the skin color of the head and neck was dark brown.At 4 months of follow-up,his skin color of the head and neck was significantly lighter,but not returned to its original appearance.