Hi,

Thanks for posting the query.

After going through your query, I would like to comment the following:

1. The medical history is suggestive of pneumonia.

2. In such a condition the causes of associated hypotension are commonly septicemic shock, dehydration or addisonian crisis. A seperate cardiac involvement could also be the cause.

3. Remember septicemic shock is sepsis with refractory arterial hypotension or hypoperfusion abnormalities in spite of adequate fluid resuscitation.

4. Norepinephrine and vasopressin are indicated in such cases. However the response in such conditions can be poor because septicemic shock is an advanced stage sometimes involving multiple organs (multi organ failure).

5. Most important treatment plan is control of infection as fast as possible.

I hope I have answered your query. I will be glad to answer any follow up queries.

Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB

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