death from Gray Baby Syndrome due to mistaken overdosage chloramphenicol

A one-year-old boy took 2 tablets of chloramphenicol(0.5 g)and swallowed when playing alone, the tablets were put on the table by his mother. The boy developed dysphoria, nausea, vomiting, abdominal distention, slight cyanosis, dyspnea, and tachycardia 4.5 hours after the accidental medication. Laboratory tests showed the following values: carbon dioxide-combining power 14.0 mmol/L, creatine kinase 137 U/L, creatine kinase isoenzyme 45.0 U/L, lactate dehydrogenase 635 U/L, myoglobin weakly positive.ECG showed atrial fibrillation with rapid ventricular rate.The boy was diagnosed as:(1)Gray Baby Syndrome due to chloramphenicol;(2)myocardial injury;(3)possibly complicated with metabolic acidosis. He underwent comprehensive treatments immediately including oxygen inhalation, inotropic agents,and diuresis.The boy developed cyanosis on face and lip, heart failure, pulmonary edema, and unconsciousness. Finally, the boy died despite resuscitation attempts about 10 hours after the accidental swallowing of chloramphenicol. Key words: Chloramphenicol; Gray Baby Syndrome