Abstract
RATIONALE: Polymyxin B is a widely used antibiotic in clinical practice, and anaphylactic shock represents a severe adverse drug reaction. Reports of polymyxin B-induced anaphylactic shock are rare in the existing literature. PATIENT CONCERNS: A 67-year-old male patient in the recovery phase of cerebral infarction presented with fever. The suspected pathogen responsible for his pulmonary infection was drug-resistant Pseudomonas aeruginosa, which is resistant to polymyxins. Following the administration of polymyxin B, the patient experienced anaphylactic shock. DIAGNOSIS: Consider the anaphylactic shock induced by polymyxin B. INTERVENTIONS: Adrenaline was administered via intramuscular injection, and a micro-pump of metaraminol was utilized for infusion. Fluid resuscitation, intravenous dexamethasone administration, and nebulized budesonide were also performed. Consequently, the patient's blood pressure gradually returned to normal levels. OUTCOME: The patient was transferred to the respiratory department for further treatment. LESSONS: To prevent serious adverse reactions, it is essential to strictly adhere to indications and contraindications to avoid misuse and minimize the occurrence of adverse effects. Prior to medication administration, a thorough inquiry into the patient's drug allergy history and family history should be conducted.