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HOMOEOPATHIC APPROACH TO ERUPTIVE FEVERS

HOMOEOPATHIC APPROACH TO ERUPTIVE FEVERS. CASE 1. A four year old female child came with complaints of fever with vesicular eruptions all over the body since 1 day with severe burning pains on slightest touch. EVOLUTION. Complaints started with throat pains since 3 days. A/F oily food .

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HOMOEOPATHIC APPROACH TO ERUPTIVE FEVERS

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  1. HOMOEOPATHIC APPROACH TO ERUPTIVE FEVERS

  2. CASE 1 A four year old female child came with complaints of fever with vesicular eruptions all over the body since 1 day with severe burning pains on slightest touch.

  3. EVOLUTION Complaints started with throat pains since 3 days. A/F oily food . 2 days later started with fever which was high grade with chilliness. Since 1 day vesicular eruptions started on face and now spread to trunk back and upper extremity. Burning pains <3 slightest touch >2 draft of air Itching minimal. Has become cranky and weepy due to pain. Appetite decreased. Thirst – increased sips of water frequently.

  4. EXAMINATION FINDINGS General Examination: Temp :- 101O F Pulse :- 110/min Chest :- Clear CVS:- S1, S2 normal. Throat- Congested Local Examination:- Vesicular discrete eruptions on back ,face and upper extremity.

  5. ACTION:- • Placebo • Orientation of mother regarding diagnosis.

  6. FOLLOW UP IN 2 DAYS:- Weepiness SQ. Appetite- Decreased Thirst – Desire to drink but refuses to drink due to throat pain, takes only sips of water. Fever – Same ,high grade. Vesicle – Now spread to legs. Eruptions increasing in size having a bluish hue. Burning pains increased- Fear of being touched 3+

  7. EXAMINATION FINDINGS:- Temp :- 102o F Pulse :- 130/min Throat :- Pus pockets bilateral Tongue :- Coated Skin :- Bluish vesicular eruptions +

  8. TOTALITY:- • Irritability fever during • Irritability pain during • Fear of being touched 3+ • Thirst : small quantities often • Burning pains < touch 3+ > draft of air 2+ • Throat pain < swallowing. • Eruptions – bluish vesicle.

  9. ACTION ARS ALB 200 1P STAT

  10. FOLLOW UP AFTER 2 DAYS ACTION- ARS ALB 200 1P STAT • ACTIVE ,PLAYFUL • NO FEVER • NO THROAT PAIN • NO BURNING PAIN • SKIN- LARGE ERUPTIONS STILL NOT DRIED

  11. FOLLOW UP AFTER 6 DAYS • SKIN LESSIONS HEALED • NO OTHER COMPLAINTS ACTION- Placebo Later on follow up with constitutional remedy- NATRUM MUR 200 1P

  12. Case 2 1 year old child comes with high grade fever with cough since 10 days.

  13. Chief Complaint 25-2-06 Location Sensation Modality Concomitant Coryza watery Cough wet Rattling, ends in vomiting Vomitus Sticky Respiratory system Sing 10 days Irritability2 Desire to be carried on shoulder Activity 2 Thirst 2 Lachrymation A/F: ? < Night2 < night Not > allopathic Medicine High grade fever Since 7 days

  14. EXAMINATION FINDINGS Child moaning continuously Crying on being examined Temp: 103oF Weight 9 kg RR 60/min Tg: Thick white coated RS: Crepitations++ bilateral P/A Liver 1 finger palpable spleen Not palpable CVS S1 S2 NAD Skin Mild Maculopapular rash on chest.

  15. INVESTIGATION on 25-2-06 Hb 9.9 TC 8400 N 59 L 37 E 2 M 2 MP NAD Widal O: 1:30 H: 1:30 X-Ray: chest Bil lower zone broncho pneumonia

  16. DIAGNOSIS Complicated measles with bilateral broncho pneumonia

  17. INDICATIONS FOR ADMISSION • Measles overall decreases the immunity and hence predisposes to infective illness and its complications. Broncho pneumonia is one of them. Measles pneumonia is known to spread rapidly. MONITOR VITAL SIGNS IN VIEW OF IMPENDING COMPLICATION • High grade fever, high respiratory rate and decreased thirst and appetite will lead to water, electrolyte and nutrition imbalance • To observe remedy reaction in a case of eruptive fever

  18. ANCILLARY MEASURES • ISOLATION: As it is an infective illness and also to prevent cross infection from other patient as the immunity is low • TPR: two hrly. • Plenty of oral fluids • I.V. fluids

  19. TOTALITY • A/F: Eruption fail to appear • Irritability fever during • Carried desire to be on shoulder • Thirstlessness heat during • Vomiting coughing on • Rattling cough < night

  20. REMEDIES FOR DIFFERENTIATION Ant. Tart, Sulph, Cham, Cina and Lach Cham and Cina: Not covering cause Lach: Not covering mental concomitant of carried desire to be Sulph: Suppression of eruption Ant. Tart: Eruption fails to appear

  21. FOLLOW UP Within few dose Rash appeared all over body Within 24 hr fever settled 3-4 days cough settled completely X-Ray on 27-2-06 Resolving patch X-Ray on 2-3-06 Normal

  22. IMPORTANT LEARNING • Importance of examination • Clinico Pathological Co-relation • Susceptibility assessment • Remedy response evaluation

  23. COURSE OF ERUPTIVE FEVER • Viral infections • Specific well defined course • Self limiting illness • If the course is tamperedprotracted illness complications

  24. Eruptive fevers (therapeutic flow chart) Normal Deviant Complications course course course Identification Identification Orientation Orientation of characteristics to parents Wait and watch Infrequent repetition Infrequent to frequent repetition

  25. IMPORTANT CONCEPTS • Knowledge of illness • Knowledge of complication • Identification of right remedy • Assessment of susceptibility • Suppression • Minimum repetition • Follow up assessment

  26. THANK YOU

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