BackgroundPolymyxin B (PMB), which is regarded as the ultimate antibacterial treatment against some intractable gram-negative bacteria with its outstanding anti-bacterial activities, inflicts several adverse effects on patients. However, skin hyperpigmentaion (SH) induced by PMB is very rare. Here, we report a case of polymyxin B-induced skin hyperpigmentation (PMB-iSH) in a 21-year-old female. To the best of our knowledge, this is the first case of PMB-iSH in China.Case presentationA 21-year-old female patient with sepsis received the administration of PMB by intravenous injection for the treatment of multi-drug resistant Klebsiella pneumoniae (MDR-KP) infection. She later suffered from a rare adverse drug reaction (ADR), namely PMB-iSH, after 5-day PMB administration during her treatment. There were multiple red rashes spread on the whole body skin at first. With the rashes fading away, SH with dark round spots appeared, associated with no pain or pruritus. The skin of the head and neck was darkened evidently, and dark brown spots were spread on the skin of trunk and limbs. About a month after her admission, urged by the relatives, the patient was transferred back to the local hospital for further treatment in the end, and her skin color didn’t recover to the previous state at that time.ConclusionBoth our case and the literature review highlight that PMB can give rise to SH indeed. Clinicians and pharmacists should attach great importance to this rare pigmentary disorder and further investigation is warranted.

Multilegged robots have the potential to serve as assistants for humans, replacing them in performing dangerous, dull, or unclean tasks. However, they are still far from being sufficiently versatile and robust for many applications. This paper addresses key points that might yield breakthroughs for highly dynamic multilegged robots with the abilities of running (or jumping and hopping) and self-balancing. First, 21 typical multilegged robots from the last five years are surveyed, and the most impressive performances of these robots are presented. Second, current developments regarding key technologies of highly dynamic multilegged robots are reviewed in detail. The latest leg mechanisms with serial-parallel hybrid topologies and rigid–flexible coupling configurations are analyzed. Then, the development trends of three typical actuators, namely hydraulic, quasi-direct drive, and serial elastic actuators, are discussed. After that, the sensors and modeling methods used for perception are surveyed. Furthermore, this paper pays special attention to the review of control approaches since control is a great challenge for highly dynamic multilegged robots. Four dynamics-based control methods and two model-free control methods are described in detail. Third, key open topics of future research concerning the mechanism, actuation, perception, and control of highly dynamic multilegged robots are proposed. This paper reviews the state of the art development for multilegged robots, and discusses the future trend of multilegged robots.

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