Clinical Cases

Right Lung Abscesses

Sanjay Padole
Written by

The author presents a case of lung abscess in an 18 month old child, fully documented including X-rays and cured with Pulsatilla.

Age: – 18 months, Sex: – Male

Date: 4/11/2009

ODP: Complaints started with coryza, with fever treated with allopathic medicine and patient remained normal for 4days. After 4 days same complaints reoccurred followed by dyspnoea.

  • Chest X ray – right lung effusion.
  • Hb – 5.7 gm%
  • Patient underwent ICU admission and ICD on 14/10/2009.
  • Patient was discharged on 05/11/2009 and was suggested for right lung decortications.

Milestone – delayed talking and walking. Always remains sick.

  • PRETERM LSCS Delivery.
  • LBW – 1.75 kg.

Past history – Jaundice after birth ; sr.bilirubin – 20. underwent NICU stay for 15 days.

  • rattling after sleeping since 1 month of age.
  • H/O recurrent coryza with fever < change of weather; during which he becomes dull with sleepy, appetite reduced, thirstless and thermal hot.
  • Patient received blood transfusion, inj. pipzo, vancomycin, Augmentin, Syp Azithral.

Family history – Tubercular background in family both maternal as well as paternal side.

Perspiration – profuse over scalp, forehead and upper lips.

Desires – Banana, maagi, milk, earth, pungent things.

Aversion – sweet.

Thirst – Thirsty but thirstless in acute conditions.

Mind – anger when contradicted = violent anger and used to beat his head on ground.

  • follows all instruction given by his relatives.
  • Attached to mother.
  • Plays alone.
  • Always remains happy.
  • Does not like to play with girls.

O/E Chest – Air entry on right side is less.

Investigations:-

CT scan Chest: – dated 14/10/2009.

– ICD in situ on right side.

– Consolidation collapse of right lung with shift trachea & mediastinum to opposite side.

– Right pleural effusion.

– Consolidation involving posterior basal segment of left lung.

– Screening of abdomen reveals gaseous distention of bowel loops.

X. Ray Chest: – dated 14/10/2009.

– Right gross pleural effusion with collapse underlying lung.

X. Ray Chest: – dated 24/10/2009.

– Cavitatory lesions in right mid zone & right lower zone suggestive of? Pneumotocoele with surrounding consolidation.

– Right pleural effusion.

X. Ray Chest: – dated 28/10/2009.

– Patchy opacities with pneumotoceles in right lung.

– Right pleural effusion.

As compared to previous radiograph there is no significant changes.

CT scan Chest: – Dated 03/11/2009.

  • Thick walled cavities with septae & air fluid level within right upper & middle lobes with air fluid level & surrounding consolidation suggestive of multiple lung abscesses.
  • Fibrotic changes in right lobe.
  • Minimal right sided pleural effusion.

Pleural fluid analysis:-

S/O Exudative, 4.8 protein, plenty of pus cells, 10-15 RBC.

Diagnosis of diseases: – Right lung abscesses.

Phase of disease: – Acute reversible.

Diagnosis of miasm: – Tubercular.

Diagnosis of susceptibility: Moderate.

Diagnosis of remedy: – Pulsatila, Lycopodium, Sulphur, Lachesis, carb.veg, bryonia alba .

Selection of remedy: – Pulsatila 6c 3 dose stat.

Date with Sr.noObservation &
interpretation
Prescription given
10/11/2009CXR of 9/11/2009 noted

– Cavities in right mid zone with surrounding

Consolidation.

– Right pleural effusion.

Weakness improved, Appetite improved, dullness

Reduced, irritability decreased, thirst increased.

No fever, no cough,

Chest – Clear

S.L
17/11/2009No fever, no cough, no breathlessness.

Activity increased, appetite increased, sleep normal.

Chest – AEEBS/ clear.

No history of recurrent coryza / fever even though

there is change of weather.

S.L
22/11/2009Sneezing since yesterday.

Coryza since today

Desires magi, pungent, apple, banana, milk.

Aversion sweet, Thirsty, Hot.

Chest – Clear.

Pulsatila – 200 1

Dose.

2/12/2009CXR of 1/12/2009 Noted.

Cavitatory lesion with surrounding consolidation in

right mid & lower zone.

Coryza since yesterday.

Sneezing +, cough +, thirsty +, Hot.

No fever.

Chest – Clear.

Pulsatila – 200 1

Dose.

1/1/2010CXR of 16/12/2009 noted.

? Cavitatory lesion in right mid zone

H/O eating groundnut yesterday.

Irritability since yesterday = sleepy.

Appetite decreased, feverish, Hot, thirsty, wants

to be carried.

No coryza, no cough.

Chest – Clear.

S.L
11/1/2010CXR of 8/1/2010 noted

No significant abnormality
detected.

Patient had no any
complaints

S.L

Further follow up is given below the reports and x ray films given below.

Scanned copy of printed reports & photo copy of x ray films of patient are attached.

Before Treatment.

First. Date: – 14/10/2009. Sr. No – 474.

Before Treatment.

Second. Date:- 24/10/2009. Sr. N0 – 755

Before Treatment.

third. Date:- 28/10/2009. Sr. N0 – 896.

Before Treatment.

During Treatment.

Fourth. Date:- 9/11/2009. Sr. N0 – 279.

During Treatment.

Fifth. Date:- 1/12/2009. Sr. N0 – 16.

During Treatment.

sixth. Date:- 16/12/2009. Sr. N0 – 617.

During Treatment.

Seventh. Date:- 8/01/2010. Sr. No – 284.

Date :- 28/02/2010.

H/o eating ice cream.

Coryza with watery discharge since 2 days.

Cough < lying down.

Sneezing +

Fever since 2 days.

Thirsty +

No drowsy / dullness.

Sweating over – upper lips, forehead, neck.

Lips red.

Chest – clear.

Remedy given – pulsatilla 200 1 dose.

Date:- 14 / 03/ 2010.

H/o fright due his mother try to beat him in evening.

Next day morning he get fever with convulsion.

Activity decreased, fever, chills, shivering, thirsty.

Thirsty during fever.

Sleepiness ++

Desires to lying on abdomen.

Fever with coryza.

Chest X. ray done – No abnormality detected.

Remedy given – opium -200 1 dose.

Date – 17 / 03 / 2010.

No any complaints.

No fever

No coryza

Remedy given – S.L.

About the author

Sanjay Padole

Sanjay Padole

Dr. Sanjay Gavaji Padole M.D "“ graduated from Dr. Babasaheb Ambedkar Marathwada University and Shri Bhagwan Homoeopathic medical college, Aurangabad. He worked as Resident medical officer at Seth Nandlal Dhoot Hospital Aurangabad and trained at Homoeopathic Education And Research Institute, Dr Kishor Mehta. Vileparle, Mumbai. Since 2003 he"™s has had his own clinic at Mit hospital Cidco, n-4, Aurangabad,Maharashtra, India. His special interests include Indian mythology.

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9 Comments

  • Dear Dr Sanjay,

    Thanks for sharing a wonderful clinical case presentation.
    In today’s era of clouding over the objectivity of homeopathic efficacy, such cases with imaging evidences will always help at various platforms.

    I was curious to know, why did you shift from 6c to 200th potency directly [on 22 Nov]? For 6c, i guess, you were thinking of the structural pathology in mind.

    Best regards,
    Dr Amit Karkare

  • I want to ask the author as to whether the patient was also on antibiotics or any other allopathic medicine during the time, he was taking homeopathic medicine ‘Pulsatilla’ ? Thanks!

  • Dear Sanjay

    Congrats dear!!!

    This is an excellent achievement and wonderful presentation of the case!
    I believe in your extra ordinary talent and hats off to your patience throughout till date to achieve this milestone in your career.
    I am sure you have even more such amazing cases and I hope to see them soon on this portal online.
    Great work and good luck.

    Warm Regards,
    Geeta

  • Dear Dr. Sanjay Gavaji Padole M.D.
    I am very moved by your confidence and observation power. Good work. I am very inspired by your work. I am working with FOP, do you have any experience? If yes then pls share with me.

    • Dear sir,
      It is already been mentioned in case that he had one episode of “convulsion” and hence was given the OPIUM as he was having FEVER.

      Thank you for the responce.

      Dr.Sanjay Padole

  • Dear Dr.Sanjay PADOLE
    I am very happy for wounderful case with good work. I belive in your hard work in H-PATHY I hope you will be successin different difficult cases and best wishes for further work.

  • i like homeopathy very much. being a veterinarian i also use h.remedies for animals. it is polite type of treatment. i love homeopathy. and want to become expert. and i hope u will guide me thank u very much. Muhammad aadil Mann student DVM university of agricultre faisalabad Punjab Pakistan