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Rare occurrence of polymyxin B-induced hyperpigmentation in a child with ventriculitis
  1. Diana Noma Fitzrol1,
  2. Song Yee Ang1,
  3. Asyraf Suhaimi2 and
  4. Tat Boon Yeap3
  1. 1Department of Neurosciences, School of Medical Sciences, Hospital Universiti Sains Malaysia, Kota Bahru, Kelantan, Malaysia
  2. 2Clinical Pharmacy & Drug Information Unit, Hospital Universiti Sains Malaysia, Kota Bahru, Kelantan, Malaysia
  3. 3Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
  1. Correspondence to Dr Tat Boon Yeap; boontat{at}


Polymyxin B (PB) is a polypeptide bactericidal antibiotic that is commonly used for extensively drug-resistant (XDR) microorganisms such as Acinetobacter baumanii and Klebsiella pneumoniae. It can be administered intravenously or intrathecally. Common side effects are nephrotoxicity, neurotoxicity, pruritus and skin hyperpigmentation (SH). The latter is an uncommon adverse reaction of intravenously administered PB. We report a rare occurrence of PB-induced SH secondary to intrathecal administration of PB in a child with A. baumanii XDR ventriculitis. We describe the management of him and a brief review of PB.

  • Anaesthesia
  • Infections
  • Hydrocephalus

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  • Contributors DNF and SYA are the neurosurgeons who managed the patient and coauthored this manuscript. TBY was the neuroanaesthesiologist who managed this patient and coauthored this manuscript. AS was the clinical pharmacist who was in charge of this patient’s antibiotics.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.