Gray baby syndrome | |
---|---|
Other names | Grey baby syndrome, gray syndrome, grey syndrome |
Specialty | Pediatrics, infectious disease, toxicology |
Symptoms | Vomiting, greenish diarrhea, abdominal distension, hypothermia, pallid cyanosis, irregular respiration, circulatory collapse |
Complications | Bleeding, hepatic failure, anemia, kernicterus, death |
Usual onset | Neonates |
Causes | Accumulation of chloramphenicol |
Diagnostic method | proper history taking, monitoring blood level of the drug |
Gray baby syndrome (also termed gray syndrome or grey syndrome) is a rare but serious, even fatal, side effect that occurs in newborn infants (especially premature babies) following the accumulation of the antibiotic chloramphenicol.[1] Chloramphenicol is a broad-spectrum antibiotic that has been used to treat a variety of bacteria infections like Streptococcus pneumoniae as well as typhoid fever, meningococcal sepsis, cholera, and eye infections.[2][3] Chloramphenicol works by binding to ribosomal subunits which blocks transfer ribonucleic acid (RNA) and prevents the synthesis of bacterial proteins.[4][5] Chloramphenicol has also been used to treat neonates born before 37 weeks of the gestational period for prophylactic purposes.[2][6][4] In 1958, newborns born prematurely due to rupture of the amniotic sac were given chloramphenicol to prevent possible infections, and it was noticed that these newborns had a higher mortality rate compared with those who were not treated with the antibiotic.[7] Over the years, chloramphenicol has been used less in clinical practice due to the risks of toxicity not only to neonates, but also to adults due to the risk of aplastic anemia.[3][8][9] Chloramphenicol is now reserved to treat certain severe bacteria infections that were not successfully treated with other antibiotic medications.
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