Open AccessPolymyxin B-induced rhabdomyolysis
Author(s) -
Ming Ni,
Xiangdong Meng,
Limin Wang,
Yanan Zhao,
Min Yu,
Sheng Ying Shi
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000022924
Subject(s) - medicine , rhabdomyolysis , polymyxin b , polymyxin , acinetobacter baumannii , creatine kinase , adverse effect , antibiotics , anesthesia , surgery , gastroenterology , microbiology and biotechnology , bacteria , genetics , pseudomonas aeruginosa , biology
Rationale: Polymyxin B has been used to treat extensively drug-resistant gram-negative bacteria and shown a better antibacterial effect in the clinic at present. Meanwhile, polymyxin B is associated with several adverse effects. However, there is a lack of awareness that polymyxin B can cause rhabdomyolysis. In this study, we firstly report a case of polymyxin B-induced rhabdomyolysis during antiinfection therapy. Patient concerns: A 70-year-old woman suffering from rheumatic heart disease underwent aortic and mitral valve replacement at our institute. Subsequently, she developed bacteremia and pneumonia caused by extensively drug resistance-acinetobacter baumannii. Polymyxin B was administered for 5 days. During treatment, the patient complained of muscle pain and limb weakness, and her serum creatine phosphokinase and myoglobin levels rose. Diagnosis: The clinical symptoms and laboratory examination confirmed rhabdomyolysis, and polymyxin B-induced rhabdomyolysis was considered. Intervention: We ceased polymyxin B treatment and monitored the patient daily. Outcomes: Serum creatine phosphokinase levels returned to normal, myoglobin levels decreased, and muscle pain was significantly alleviated after cessation of polymyxin B. We identified this as a case of polymyxin B-induced rhabdomyolysis. Lessons: Here, we report the first reported case of rhabdomyolysis induced by polymyxin B administration. The awareness of rare adverse reaction helps ensure the clinical safety of polymyxin B treatment.