PMC8353103_01
Brain magnetic resonance imaging (MRI) and computed tomography (CT) image after patient admission. (A) Sagittal enhanced MRI of pituitary showed enlarged sella turcica with a mass of about 1.2 cm x 1.6 cm x 1.4 cm in it, pituitary stalk extension to the right side and optic chiasm compression pituitary (January 25, 2019). (B) Sagittal enhanced MRI of pituitary showed that the craniopharyngioma was completely removed, and the skull base was incompletely covered by mucosal flap (January 29, 2019). (C) On day 47 of admission (March 12, 2019), nonenhanced skull CT scan revealed that the cerebrospinal fluid leakage was successfully repaired owing to the skull base reconstruction with mucosal flap. (D) Whole-spine MRI revealed no obvious adhesion in the spinal canal after 4 days of polymyxin B treatment (March 19, 2019). Follow-up pituitary MRI revealed (E) no recurrence of tumor, well healed mucosal flap in skull base, and (F) no obvious hydrocephalus (January 16, 2020).
fped-09-564991-g0001.jpg
PMC8353103_04_fped-09-564991-g0001.jpg
F1
Radiological signs were also normal (Figures 1E,F).
PMC8353103_02
Brain magnetic resonance imaging (MRI) and computed tomography (CT) image after patient admission. (A) Sagittal enhanced MRI of pituitary showed enlarged sella turcica with a mass of about 1.2 cm x 1.6 cm x 1.4 cm in it, pituitary stalk extension to the right side and optic chiasm compression pituitary (January 25, 2019). (B) Sagittal enhanced MRI of pituitary showed that the craniopharyngioma was completely removed, and the skull base was incompletely covered by mucosal flap (January 29, 2019). (C) On day 47 of admission (March 12, 2019), nonenhanced skull CT scan revealed that the cerebrospinal fluid leakage was successfully repaired owing to the skull base reconstruction with mucosal flap. (D) Whole-spine MRI revealed no obvious adhesion in the spinal canal after 4 days of polymyxin B treatment (March 19, 2019). Follow-up pituitary MRI revealed (E) no recurrence of tumor, well healed mucosal flap in skull base, and (F) no obvious hydrocephalus (January 16, 2020).
fped-09-564991-g0001.jpg
PMC8353103_04_fped-09-564991-g0001.jpg
F1
Radiological signs were also normal (Figures 1E,F).
Clinical course and skin hyperpigmentation of the patient. (A) Body temperature over the course of treatment. (B) White blood cell (WBC) count in the peripheral blood. (C) Neutrophil percentage (NEUT%) in the peripheral blood. (D) Serum creatinine (SCr) levels. (E) Skin hyperpigmentation and dark red papule appeared in the upper part of trunk of patient on the fourth day of polymyxin B treatment (March 18, 2019). (F) Skin hyperpigmentation gradually disappeared (January 16, 2020).
fped-09-564991-g0002.jpg
PMC8353103_04_fped-09-564991-g0002.jpg
F2
Skin hyperpigmentation (Figure 2F) and strength in his limbs were gradually recovered, and the patient could walk normally.
Levels of tigecycline and polymyxin B in cerebrospinal fuid (CSF) of the patient. (A) CSF tigecycline concentrations were measured with Two-Dimensional High-Performance Liquid Chromatography (2D-HPLC) method. (B) CSF polymyxin B levels were determined using high performance liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Red circle represents the day of ITH polymyxin B treatment.
fped-09-564991-g0003.jpg
PMC8353103_03_fped-09-564991-g0003.jpg
F3
CSF was performed with HPLC-MS/MS equipped with electrospray (ESI) ionization interface (Figure 3B). CSF sterilization (a negative CSF culture) was achieved the next day, following remarkable improvement in CSF findings.
PMC8353103_03
Brain magnetic resonance imaging (MRI) and computed tomography (CT) image after patient admission. (A) Sagittal enhanced MRI of pituitary showed enlarged sella turcica with a mass of about 1.2 cm x 1.6 cm x 1.4 cm in it, pituitary stalk extension to the right side and optic chiasm compression pituitary (January 25, 2019). (B) Sagittal enhanced MRI of pituitary showed that the craniopharyngioma was completely removed, and the skull base was incompletely covered by mucosal flap (January 29, 2019). (C) On day 47 of admission (March 12, 2019), nonenhanced skull CT scan revealed that the cerebrospinal fluid leakage was successfully repaired owing to the skull base reconstruction with mucosal flap. (D) Whole-spine MRI revealed no obvious adhesion in the spinal canal after 4 days of polymyxin B treatment (March 19, 2019). Follow-up pituitary MRI revealed (E) no recurrence of tumor, well healed mucosal flap in skull base, and (F) no obvious hydrocephalus (January 16, 2020).
fped-09-564991-g0001.jpg
PMC8353103_04_fped-09-564991-g0001.jpg
F1
Radiological signs were also normal (Figures 1E,F).
Clinical course and skin hyperpigmentation of the patient. (A) Body temperature over the course of treatment. (B) White blood cell (WBC) count in the peripheral blood. (C) Neutrophil percentage (NEUT%) in the peripheral blood. (D) Serum creatinine (SCr) levels. (E) Skin hyperpigmentation and dark red papule appeared in the upper part of trunk of patient on the fourth day of polymyxin B treatment (March 18, 2019). (F) Skin hyperpigmentation gradually disappeared (January 16, 2020).
fped-09-564991-g0002.jpg
PMC8353103_04_fped-09-564991-g0002.jpg
F2
Skin hyperpigmentation (Figure 2F) and strength in his limbs were gradually recovered, and the patient could walk normally.
Levels of tigecycline and polymyxin B in cerebrospinal fuid (CSF) of the patient. (A) CSF tigecycline concentrations were measured with Two-Dimensional High-Performance Liquid Chromatography (2D-HPLC) method. (B) CSF polymyxin B levels were determined using high performance liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Red circle represents the day of ITH polymyxin B treatment.
fped-09-564991-g0003.jpg
PMC8353103_03_fped-09-564991-g0003.jpg
F3
CSF was performed with HPLC-MS/MS equipped with electrospray (ESI) ionization interface (Figure 3B). CSF sterilization (a negative CSF culture) was achieved the next day, following remarkable improvement in CSF findings.
PMC8353103_04
Brain magnetic resonance imaging (MRI) and computed tomography (CT) image after patient admission. (A) Sagittal enhanced MRI of pituitary showed enlarged sella turcica with a mass of about 1.2 cm x 1.6 cm x 1.4 cm in it, pituitary stalk extension to the right side and optic chiasm compression pituitary (January 25, 2019). (B) Sagittal enhanced MRI of pituitary showed that the craniopharyngioma was completely removed, and the skull base was incompletely covered by mucosal flap (January 29, 2019). (C) On day 47 of admission (March 12, 2019), nonenhanced skull CT scan revealed that the cerebrospinal fluid leakage was successfully repaired owing to the skull base reconstruction with mucosal flap. (D) Whole-spine MRI revealed no obvious adhesion in the spinal canal after 4 days of polymyxin B treatment (March 19, 2019). Follow-up pituitary MRI revealed (E) no recurrence of tumor, well healed mucosal flap in skull base, and (F) no obvious hydrocephalus (January 16, 2020).
fped-09-564991-g0001.jpg
PMC8353103_04_fped-09-564991-g0001.jpg
F1
Radiological signs were also normal (Figures 1E,F).
Clinical course and skin hyperpigmentation of the patient. (A) Body temperature over the course of treatment. (B) White blood cell (WBC) count in the peripheral blood. (C) Neutrophil percentage (NEUT%) in the peripheral blood. (D) Serum creatinine (SCr) levels. (E) Skin hyperpigmentation and dark red papule appeared in the upper part of trunk of patient on the fourth day of polymyxin B treatment (March 18, 2019). (F) Skin hyperpigmentation gradually disappeared (January 16, 2020).
fped-09-564991-g0002.jpg
PMC8353103_04_fped-09-564991-g0002.jpg
F2
Skin hyperpigmentation (Figure 2F) and strength in his limbs were gradually recovered, and the patient could walk normally.