Answer :USMLE step 2 Mcq 322:A neonate on the 5th day of life was diagnosed to have developed severe meningitis




Correct Answer: A

Chloramphenicol is the drug of choice in Haemophilus influenza due to its high efficacy against H.influenza.  Gray baby syndrome is the name given to chloramphenicol toxicity seen in characteristically neonates even at low therapeutic levels. The cause for this is that neonates have an immature hepatic function and lack an effective glucoronic acid conjugation mechanism for degradation and detoxification of chloramphenicol. So even at low therapeutic levels the drug accumulates in the body causing toxicity which is manifested by vomiting, flaccidity, hypothermia, gray color and ultimately shock and collapse.


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