Indian pediatrics
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Reports of successful use of vasopressin in various shock states and cardiac arrest has lead to the emergence of vasopressin therapy as a potentially major advancement in the management of critically ill children. ⋯ In view of the limited clinical experience, and paucity of randomized controlled trials evaluating these drugs in pediatric population, currently no definitive recommendations on vasopressin/terlipressin use can be laid down. Nevertheless, available clinical data supports the use of vasopressin in critically ill children as a rescue therapy in refractory shock and cardiac arrest.
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Streptococcus viridans is usually considered to be nonpathogenic in healthy patients. Some strains become penicillin-resistant and cause life-threatening infections in immuno-compromised patients. We report an immunocompetent boy who had community-acquired S. viridans pneumonia that was resistant to penicillin. Clinicians should note local patterns of virulence and antibiotic resistance in S. viridans and adjust treatment strategies accordingly.