Gray Baby Syndrome

Gray Baby Syndrome is a rare circulatory collapse in premature and newborn infants caused by excessive chloramphenicol serum levels. Symptoms include an ashen-gray color, abdominal distention, vomiting, cyanosis, and circulatory collapse, typically appearing 2 to 9 days after treatment starts. It results from chloramphenicol impairing myocardial contractility, especially in neonates, due to limited chloramphenicol metabolism and excretion. Reports of accidental overdoses in children and adults exist. Serum levels over 50 mg/L may lead to this syndrome, often associated with unexplained metabolic acidosis. Chloramphenicol, initially used for typhoid, still holds relevance due to its low cost and broad-spectrum coverage. However, careful dosing is crucial, especially in newborns.