Gray baby syndrome
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| ICD-10 | P93. |
|---|---|
| ICD-9 | 779.4 |
| MedlinePlus | 007049 |
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]
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[edit] 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]
[edit] 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
[edit] Treatment
Chloramphenicol therapy is discontinued immediately; exchange transfusion may be required to remove the drug.
[edit] Prevention
The condition can be prevented by using chloramphenicol at the recommended doses and monitoring blood levels.[3][4][5]
[edit] 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.
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