Fulminant heptic failure in a child following paracetamol overdosing

A previously well 6 year old boy weighing 18 kg was admitted to hospital with fever and vomiting of 6 days' and increasing drowsiness and haematemesis one days' dura tion. He had been treated with paracetamol, oral penicillin, promethazine, haloperidol, phenobarbitone, a brand of paracetamol at a dose of 730 mg three times a day for 3 days (125 mg/kg/day), and an another brand of paracetamol at a dose of 250 mg/kg/day from the day before admission.