Clinical Cases

A Case of Brain Abscess

Last modified on August 18th, 2016

Human brain
Sunirmal Sarkar
Written by Sunirmal Sarkar

Dr. Sunirmal Sarkar presents a seemingly hopeless case of brain abscess complicated with respiratory distress.

Abstract:

A girl one and half years old suffering from brain abscess complicated with respiratory distress and nearly dead ,was referred from the hospital as “inoperable”.  She experienced a revival through a series of homoeopathic medicines, administered as the symptoms and situation demanded.

The mother was crying. She was accompanied by three to four people as she  entered my consultation room. All looked anxious and worried. On the mother’s lap a pale, sunken, sleepy, girl child was lying. Her head and face was full of clammy perspiration. There was no need of auscultation, as everyone present could clear hear the rattling sound from the chest.

“Please save my child, since morning she is not suckling my breast milk”—— The mother was unable to complete the sentence. The child was in a near to death condition. I was also in an emotional state. No, I have to shake off —“How did this happen?”

Her father answered my question, “In the last few days we have been referred from hospital to hospital. Initially from child hospital to post graduate institute to institute of neurology surgical ward. There has been a hectic rise of temperature the past few days along with nearly persistent vomiting. The doctors there have tried their level best. Day before yesterday night I had called you for my child.

The doctors said that the child is in a bad state suffering from brain abscess and even operation is extremely risky. Three days back my kid had got Pyrogen 10m two doses as had you advised over the phone .Since then there has been no hectic rise of temperature, but the doctors had informed me that along with brain abscess, even lower respiratory tract infection is developing We brought our child to you directly from ICU. ”

My analytical mind decided that though the fever had reduced, this is not the state of Pyrogen which was prescribed on the basis of disproportionate temp with pulse During my telephone discussion I had asked them to count the pulse. It was 140 per minute, though that time fever was less than 100 degrees Fahrenheit. Our masters have successfully controlled this type of situation, even when there was no antibiotics and steroids. Let me replicate a drug picture of Master Kent :

“Face: About the first thing we see in the study of an Antimonium tart. Patient is expressed in the face. The face is pale and sickly; the nose is drawn and shrunken; the eyes are sunken and there are dark rings around the eyes. The lips are pale and shriveled. The nostrils are dilated and flapping, and there is a dark, sooty appearance inside of the nostrils.  The face is covered with a cold sweat and is cold and pale. The expression is that of suffering. The atmosphere of the room is pungent, more pungent than foetid or putrid, and makes you feel that death is in it.

The family is disturbed; they are going hither and thither, and the nurse is in an excited and busy state, and you enter upon this scene to make a homoeopathic prescription.  It is one of excitement and one that you cannot act rapidly in, but one in which you must make a very quick prescription. These things will interfere somewhat with your thinking at the time that you must do the best thinking and the most rapid thinking.

I prescribed Ant tart 10m every two hours. Four hours later the father informed me by phone that the child was crying in a louder tone and trying to suckle the breast milk. “Is it?” I exclaimed! The crisis was probably dissolving.

The child’s recovery was steady. Fever, gradually improving. But I was still not happy. I was seeking something more for the child. Seven days later the child had developed extremely offensive stoolseveral times a day. “What to do the parent’s asked. I told them to wait.

After four days offensiveness and frequency gradually reduced. They brought the child to my clinic- red lips, redness around rectum, offensiveness ——- Sulphur 30 one dose.

I discussed the case. Reports were showing regression of abscess, but the baby needed a longer period of treatment. Total resolution and no gliosis, otherwise she may develop neurological complications during a later stage of life. The mother was shocked on hearing this. Poor mother —– her child may suffer. She started crying.  After 3 weeks , they revisited. Not passing stools for last three to four days.  To examine, I asked the mother to lay down her child on the table. Every time mother is trying to bring her down the child starts to cry— she is trying to hold the mother strongly. Fear of downward motion, constipation, and then only one point I needed.  ”What’s the reaction of the child towards dark or in cases of power cuts (yes it is helpful, to select a remedy)?”

“She becomes scared …starts to cry.”

Sanicula 200. Two doses.

After one month symptoms improved – no fear and no constipation. Suddenly after a few weeks the child developed fever blisters on her lips, along with hang nails. (observation)

I prescribed Nat mur 10m one dose.

Next CT Scan report : further regression

After three months no more fever blisters or hang nails.

During the first week of March, loose stools vesicular eruption here and there, drooling, gingivitis, stomatitis, sleepiness —-I prescribed

Cornus circinatus 30

No more medication.

Parents brought child with latest CT scan—– no abscess, no gliosis

I told the mother that probably that child is free from future neurological danger. She held the baby firmly, kissed on her forehead. Pearls of tears from her eyes are dropping. Is she is crying?

Investigation reports

MRI on 17th September 2015 :

Findings are suggestive of rim enhancing lesions in left high frontal lobe with perifocal edema and mass effect. Features favor mature abscess.

CEST scan on 10th October 2015 read:

Rim enhancing lesions (largest 32 x 19 mm) with surrounding edema noted in left frontal lobe producing effacement of adjacent cortical sulci, Sylvian fissure, and effacement of left lateral ventricle. Suggestion of abscess in left frontal lobe with surrounding edema and mass effect as described.

CEST scan 10th November 2015 read:

Resolving rim enhancing lesions (largest 15 x 12 mm) with surrounding edema noted in left frontal lobe producing effacement of adjacent cortical sulci and Sylvian fissure.

Compared with previous CT dated 07/10/15, size of the abscess, edema and mass effect is reduced.

CEST scan 28th December 2015 read:

Ring enhancing 7 x 8 mm lesion with perilesional edema in left high partial area – tuberculoma / cysticerosis.

CEST scan 9th March 2016 read:   Compared to the previous CEST dated 30/12/15 the ring enhancing SOL in left frontal lobe is no longer visible.

Selection of Medicine:

24/9/2015 -Pyrogen 10M  29/9/2015-

Antimonium tart 10m  7/10/ 2015 –

Sulphur 30 29/10/2015- Sanicula 200

28/10/2015- Natrum muriaticum 10M

9/2/2016 – Cornus circinata  30

Discussions & Conclusion

Bacteria may enter the cerebral substance through a penetrating injury, by direct spread from paranasal sinuses or the middle ear, or secondary to septicemia. This site of abscess formation and the likely causative organism are both related to the source of infection. Initial infection leads to local suppuration followed by loculation of pus within a surrounding wall of gliosis, which is a chronic abscess that may form a tough capsule. Haematogenous spread may lead to multiple abscesses.

  1. Despite advances in therapy, the mortality rate remains at 10-20% and this may partly relate to delay in diagnosis and initiation of treatment.
  1. Source of origin was obscure – no h/o of any skin eruption, otitis media. Only tendency to cough cold tendency, paranasal sources.
  1. No f/h of any major illness. Only mother had skin eruption during later part of pregnancy.
  1. one sided case

5 series of medicines mostly based on observations and interpretations

  1. Latent psora –after medications — at different times skin eruptions appeared .
  1. Art of handling acute through homoeopathy is gradually fading during era of antibiotics and steroids

But if they fail?  The art of quick prescription to control acute situation is needed. We are making our system only for chronic diseases.

We should remember:

The unprejudiced observer – well aware of the futility of transcendental speculations which can receive no confirmation from experience – be his powers of penetration ever so great, takes note of nothing in every individual disease, except the changes in the health of the body and of the mind (morbid phenomena, accidents, symptoms) which can be perceived externally by means of the senses; that is to say, he notices only the deviations from the former healthy state of the now diseased individual, which are felt by the patient himself, remarked by those around him and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease.1 Organon –  aphorism 6

Aug 2016 Sunirmal Sarkar1

Aug 2016 Sunirmal Sarkar2

Aug 2016 Sunirmal Sarkar3

Aug 2016 Sunirmal Sarkar4

References

  1. Brian R. Walker (eds.), Nicki R. Colledge (eds.), Stuart H. Ralston (eds.), Ian D. Penman (eds.). Davidson’s Principles and Practice of Medicine. 22nd edition. : 1208-1209. Churchill Livingstone Elsevier, 2014.

About the author

Sunirmal Sarkar

Sunirmal Sarkar

Dr. Sunirmal Sarkar is one of the busiest practitioners in West Bengal. He was a professor of Materia Medica at The National Institute of Homoeopathy in Kolkata. He sees over 100 patients a day and often more than 50 cancer cases each day. In 30 years of clinical practice, Dr. Sarkar’s tremendous success in pathological cases is well known and he is an internationally known teacher. His latest book is, ‘Just You See’. His innovative approach is expressed in his case taking method, follow ups and potency selection.

7 Comments

  • What exactly date Sanicula 200 was given?
    I wonder, which of the remedies produced the fundamental cerebral progress?!
    In my experience a remedy showes at least after 24 h how far it works (same as Ant-t).
    Heinrich

  • Namaste Dr Sunirmal sir.Brain abcess case nicely handled. I am feeling refreshed .Really inspirational.Thanks A lot for sharing.

  • Great. Great talent. It is the presence of mind and high end case analytical experience. A general homeopath with simple knowledge never treat such a case; combination of many symptoms. My heart beats for such a prescription in time. A great example of Homeopathy system. Thanks for sharing both Dr. Sarkar and Facekom in bringing

  • A very very critical case is amazingly controlled by homeopathy with your exceptional Tallent. But sir what is more astonishing to me that Antim Tartaricum 10m very two hour. Such a high potency did not aggravated in this dying condition of the patient?

Leave a Comment