王斯琦 郑毅涛

    [摘要] 多粘菌素B被认为是针对某些顽固性革兰阴性菌的终极抗菌药物，它具有出色的抗菌活性，会对患者造成多种不良影响。然而，由多粘菌素B引起的皮肤色素沉着很少。报告1例多粘菌素B引起的32岁男性皮肤色素沉着过度。据所知，这在中国是很少见的多粘菌素B引起的皮肤色素沉着的案例。一例32岁男性肾移植术后脓毒症患者接受了静脉注射多粘菌素B，用于治疗多药耐药性大肠杆菌感染。此后，在治疗期间服用多粘菌素B 5 d后，其患有罕见的药物不良反应，即多粘菌素B引起的皮肤色素沉着。起初在全身皮肤上散布了多个红色皮疹。随着皮疹的消失，出现带有黑色圆形斑点的色素沉着，无疼痛或瘙痒。头颈部皮肤明显变黑，躯干和四肢皮肤上散布着黑褐色斑点。停止注射多粘菌素B大约半个月后，其病逝于脓毒性休克，那时肤色还没有恢复。案例与文献综述均证实多粘菌素B确实可以引起皮肤色素沉着。临床医生和药剂师应更加注意这种罕见的色素性疾病，也需要进一步检查。

    [关键词] 多粘菌素B;皮肤色素沉着;脓毒性休克;病例报告

    [中图分类号] R969.3? ? ? ? ? [文献标识码] C? ? ? ? ? [文章编号] 1673-9701(2021)30-0153-03

    [Abstract] Polymyxin B is considered to be the ultimate antibacterial drug against certain refractory gram-negative bacteria. It has excellent antibacterial activity and can cause many adverse effects on patients. However，skin pigmentation caused by polymyxin B is rare. Here，we report a case of hyperpigmentation in a 32-year-old male caused by polymyxin B. As far as we know，this is a rare case of skin pigmentation caused by polymyxin B in China. Case presentation：A 32-year-old male patient with sepsis received an intravenous injection of polymyxin B for the treatment of multidrug-resistant E. coli infection. After taking Polymyxin B for five days during the treatment ......