Brian D. Hanna

Medicinal leeches are used to control venous congestion. Aeromonas in the leech gut are essential for digestion of blood. This case report describes a patient who had Aeromonas bacteremia develop after leeching. He had an injury to his hand that required replantation of his thumb. Following the surgery, leech therapy was started with ampicillin-sulbactam prophylaxis. Sepsis developed. Blood cultures were positive for Aeromonas that were resistant to ampicillin-sulbactam. The antibiotic was changed to ciprofloxacin on the basis of the sensitivity profile of the organisms. Cultures from the leech bathwater confirmed it as the source of the Aeromonas. Clinicians who use leech therapy must be aware that leeches can harbor Aeromonas species resistant to accepted prophylactic antibiotics and that sepsis may occur.

Sulbactam

Bacteremia

10.4037/ajcc2009110

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Pediatric Pulmonary Hypertension

Circulation (2015)

Steven H. Abman Georg Hansmann Stephen L. Archer D. Dunbar Ivy Ian Adatia

Pulmonary hypertension is associated with diverse cardiac, pulmonary, and systemic diseases in neonates, infants, and older children and contributes to significant morbidity and mortality. However, current approaches to caring for pediatric patients with pulmonary hypertension have been limited by the lack of consensus guidelines from experts in the field. In a joint effort from the American Heart Association and American Thoracic Society, a panel of experienced clinicians and clinician-scientists was assembled to review the current literature and to make recommendations on the diagnosis, evaluation, and treatment of pediatric pulmonary hypertension. This publication presents the results of extensive literature reviews, discussions, and formal scoring of recommendations for the care of children with pulmonary hypertension.

10.1161/cir.0000000000000329

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Where do we go from here? Cardiac output determination in pediatrics*

Critical Care Medicine (2008)

Brian D. Hanna

Division of Cardiology, Children’s Hospital of Philadelphia, The School of Medicine, University of Pennsylvania, Philadelphia, PA The author has not disclosed any potential conflicts of interest.

10.1097/ccm.0b013e31816a1395

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Brian D. Hanna

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