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Chloramphenicol is metabolized by the liver. [1]

- add fussiness to the signs and symptoms section

- Gray baby syndrome should be suspected in a new born with abdominal distension, progressive pallid cyanosis, irregular respirations, and refusal to breastfeed. The cause of gray baby syndrome can come from the use of intravenous or oral chloramphenicol in neonates. It may also come from the mother's use of an antibiotic, chloramphenicol, during pregnancy or breastfeeding, but has not been confirmed by studies.

The presentation of symptoms can depend on the level of exposure of the drug to the baby. A broad diagnosis is usually needed for babies who present with cyanosis. Blood work is done to determine the level of serum chloramphenicol. Other tools used to help with diagnosis include CT scans, ultrasound, and electrocardiogram


To further evaluate chloramphenicol toxicity, a complete blood panel including serum ketones, glucose, metabolic panel should be completed to help determine if an infant has the syndrome.



  1. ^ Cummings, Earl D.; Kong, Erwin L.; Edens, Mary Ann (2021), "Gray Baby Syndrome", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 28846297, retrieved 2021-07-26