{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:36:26Z","timestamp":1782124586885,"version":"3.54.5"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gray baby syndrome is a severe adverse reaction to chloramphenicol, with a mortality rate up to 40%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We report a case in which a 14-month-old Yi boy accidentally ingested 1.5\u2005g of chloramphenicol (6\u2009\u00d7\u20090.25 g tablets) that his grandmother had left on a coffee table, mistaking them for food, which led to and was diagnosed by circulatory failure (blood pressure: 87\/50\u2005mmHg), metabolic acidosis (pH: 7.131), hypothermia (36.3\u00b0C), serum drug level (92\u2005\u03bcg\/mL), and multiorgan damage; critical interventions included mechanical ventilation, vasopressors, and delayed continuous renal replacement therapy (initiated 18\u2005h after ingestion). Besides his case, 19 other published cases were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The child recovered fully after 3 weeks with no sequelae noted at 20-month follow-up. Literature analysis revealed 64.7% survival (11\/17) and 35.3% mortality (6\/17), with fatal cases consistently showing serum chloramphenicol levels exceeding 50\u2005\u03bcg\/mL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite typical mortality risks, delayed CRRT proved pivotal in reversing toxicity in our patient. Gray baby syndrome continues to occur in underserved regions, necessitating strict drug storage, serum concentration monitoring in high-risk infants, and early CRRT implementation for survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2025.1733059","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:15:34Z","timestamp":1768205734000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Chloramphenicol-induced gray baby syndrome: case report and review of current literature"],"prefix":"10.3389","volume":"13","author":[{"given":"Yu","family":"Fang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1056\/nejm195207312470509","article-title":"Fatal aplastic anemias from chloramphenicol","volume":"247","year":"1952","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1424","DOI":"10.1136\/bmj.287.6403.1424","article-title":"Chloramphenicol toxicity in neonates: its incidence and prevention","volume":"287","author":"Mulhall","year":"1983","journal-title":"Br Med J"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.1086\/425368","article-title":"Practice guidelines for the management of bacterial meningitis","volume":"39","author":"Tunkel","year":"2004","journal-title":"Clin Infect Dis"},{"key":"B4","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1056\/nejm196004212621601","article-title":"Chloramphenicol in the newborn infant. 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