Paracetamol Overdose Causes Acute Liver Failure in Vietnamese Children

Two young children in Vietnam suffered severe liver injury after taking excessive doses of paracetamol. A 5‑year‑old boy from Tây Ninh and a 4‑year‑old boy admitted to the City Children’s Hospital in Ho Chi Minh City were given 325 mg tablets every three hours for a three‑day fever, resulting in a total dose of about 210 mg per kilogram—far above the recommended maximum of 60 mg/kg per day.

Both children presented with high fever, abdominal pain, vomiting, jaundice of the skin and eyes, and respiratory distress. Laboratory tests showed markedly elevated liver enzymes, coagulopathy, and high blood ammonia, confirming acute paracetamol‑induced liver failure. Intensive treatment included mechanical ventilation, circulatory support, electrolyte correction, intravenous N‑acetylcysteine, plasma exchange and continuous blood filtration. After more than two weeks of care, the children regained consciousness, liver function normalized, and they were discharged in stable condition.

Medical staff emphasized that paracetamol is safe only when used correctly: it should be administered only for temperatures ≥38.5 °C, at a dose of 10‑15 mg/kg per dose, spaced 4‑6 hours apart, with a daily maximum of 60 mg/kg. Parents are urged to seek professional medical advice for persistent fever rather than self‑medicating.