In developing countries there has been a long history of counterfeit cough medicine that is toxic, especially in children.
Product: cough syrup
Contaminant: diethylene glycol, ethylene glycol
Substituted for: glycerol
The substitution could be done:
(1) intentionally by the syrup producer
(2) by an unscrupulous supplier
Effect: acute renal failure, multi-organ failure, death
Differential diagnosis: reaction to propylene glycol, which is widely used in pharmaceuticals
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Specialty: Pharmacology, clinical