Right Lung Abscesses
Sanjay G. Padole, M.D.
Abstract: 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.
Follow up Chart:Date with Sr.no Observation
&
interpretation
10/11/2009
CXR 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
17/11/2009
No 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.
22/11/2009
Sneezing since yesterday.
Coryza since today
Desires magi, pungent, apple, banana, milk.
Aversion sweet, Thirsty, Hot.
Chest – Clear.
Prescription
given
S.L
S.L
Pulsatila – 200 1
Dose.
2/12/2009
1/1/2010
11/1/2010
CXR 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.
CXR 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.
CXR of 8/1/2010 noted
No significant abnormality detected.
Patient had no any complaints
Pulsatila – 200 1
Dose.
S.L
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.
Dr. Sanjay G. Padole –M.D. Homeopathy- MIT Hospital, Aulrangabad. Maharashtra, India.