Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Gray baby syndrome
Introduction
Gray baby syndrome (also termed Gray or Grey syndrome) is a rare but serious side effect that occurs in newborn infants (especially premature babies) following the intravenous administration of the antibiotic chloramphenicol.[1]
Pathophysiology
Pathophysiology
Newborn infants are predisposed to this condition because they do not yet have fully functional liver enzymes, nor do they have enough enzymes to handle the drug.[2]
Clinical features
Clinical features
Toxic levels of chloramphenicol after 2–9 days result in:
- Vomiting
- Ashen gray colour of the skin
- Limp body tone
- Hypotension (low blood pressure)
- Cyanosis blue discolouration of lips and skin.
- Hypothermia
- Cardiovascular collapse
Treatment
Treatment
Chloramphenicol therapy is discontinued immediately; exchange transfusion may be required to remove the drug.
Prevention
Prevention
The condition can be prevented by using chloramphenicol at the recommended doses and monitoring blood levels.[3][4][5]
Footnotes
Footnotes
- ↑ McIntyre J, Choonara I (2004). “Drug toxicity in the neonate”. Biol Neonate. 86 (4): 218–21. PMID 15249753.
- ↑ Piñeiro-Carrero V, Piñeiro E (2004). “Liver”. Pediatrics. 113 (4 Suppl): 1097–106. PMID 15060205.
- ↑ Feder H (1986). “Chloramphenicol: what we have learned in the last decade”. South Med J. 79 (9): 1129–34. PMID 3529436.
- ↑ Mulhall A, de Louvois J, Hurley R (1983). “Chloramphenicol toxicity in neonates: its incidence and prevention” (Scanned copy & PDF). Br Med J (Clin Res Ed). 287 (6403): 1424–7. PMID 6416440.
- ↑ Forster J, Hufschmidt C, Niederhoff H, Künzer W (1985). “[Need for the determination of chloramphenicol levels in the treatment of bacterial-purulent meningitis with chloramphenicol succinate in infants and small children]”. Monatsschr Kinderheilkd. 133 (4): 209–13. PMID 4000136.