Case chronic tonsillitis

I recently had an interesting case of an 8 year old boy suffering from severe tonsillitis, recurrent throat infections, follicular tonsillitis and fevers up to 40.5C that last for over 2 weeks. Boy also experienced chilliness and fatigues. Symptoms preceded for 4 years, getting worse; patient was prescribed stronger and stronger antibiotics, even given intravenous antibiotics at the hospital.

Analysis:

1. Diagnosis : Chronic recurrent follicular tonsillitis since 4 year old.
2. Lab tests : CBC during last exacerbation had performed, WBC was very high- 23000. Neutrophils 83%, high.
3. Main complaint : History of recurrent, severe throat infection, follicular tonsillitis, always with high fever up to 40.5 Deg. Celsius, with long duration, about 2 weeks each time, chilliness and fatigue.
4. Possible causative factor –cold weather, cold drinks

5. Modalities : Worse from ice cream, drinking cold water.
6. Time of occurrence. Usually after coming from school, where he use to drink cold water or cold juice. By the evening fever getting worse, along with pain and chilliness.
7. Side of the body: Both tonsils were affected, swollen, with patches of pus.
8. Frequency of appearance: 8-10 time per year, according to his mother information.
9. Severity of complaint: Pain in throat was so severe, he cannot swallow any food.
10. Accessory symptoms :
    • Pain in throat was accompanied with headache in forehead.
    • Patient has diarrhea during tonsillitis . During high fever has recurrent horrible dreams, such as buffalo attacking him, waking up in horror.

11. Physical generals:
    • Chilly, has cold feet at night, needs warm cover. Perspiration on occiput during sleep, pillow always wet.
    • Sleeping on right side.
    • FOOD MODALITIES: Desire eggs, omelet. Can eat 3 eggs every day. Desire sweets+++.desire salt++. Desire banana++.

12. Mental and emotional status : Has fear of dark, fear of horror movies. Cannot sleep after watching scary movies. No mental problem, studying well.
13. Personal medical history:
    • Suppressive therapies and vaccinations. Took all basic vaccines. And so many courses of antibiotics, each time stronger.
    • Physical or emotional traumas. No history of any trauma.
    • History of chicken pox 2 years back, mild form. And several acutes with tonsillitis, 8-9 times per year.

14. Family medical history: Mother has allergic bronchitis, even during pregnancy with this boy she got bad bronchitis. Took antibiotics and steroids in both, injections and nebulization. Grandmothers both have high blood pressure. One grandmother has diabetes type 2. Grandfather died at 50 years old from heart attack.
15. Analysis and prognosis:
    • Anatomopathological disturbance mostly on physical levels, on tonsils, mucous membrane, but severity is high.
    • In emotional levels he has fear of dark, horror movies and bad dreams. No mental disturbances.
    • Patient had chicken pox and frequent severe colds with high fever.
    • Family medical history and hereditary predisposition.

His mother has allergic bronchitis, so he might take this predisposition . The fact, that she was sick with severe allergic bronchitis during pregnancy with this son, and took steroids in form of injections and in nebulization, most probably had effect on his health. His immunity system was suppressed yet, in womb of mother.

Conclusion:

Level of health according Prof. Vithoulkas  theory:

Patient is in group B, levels 5-6 of health .Because he has frequent acutes with very high fever.

Prognosis is good, because major problem are physical. Even though he has some mild emotional fears. But since no family history of any deep emotional problems, he will improve with correct remedy.

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Selection of symptoms:

• Tonsillitis severe, recurrent
• Fever high
• Fear of dark
• Fear of horror movies
• Bad Dreams
• Thirst
• Chilly
• Perspiration-occiput at night,
• Eggs desire,
• Sweets desire
• Severe tonsillitis
• Very high fever
• Chilliness trembling fever, during
• Cannot swallow food

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Repertorization

1. MIND-FEAR – of dark; of
2. MIND-FEAR-horror movies;
3. MIND-DREAM; as if he in,
4. Generals-food AND drinks-eggs-desire
5. GENERALS-FOOD and DRINKS –sweets –desire
6. STOMACH-THIRST
7. THROAT-Tonsils, complaints of
8. CHILL-CHILLINESS
9. GENERALS-TREMBLING-externally-fever; during
10. HEAD, PERSPIRATION-occiput, sleep, during

10 close remedies:

CALC, SULPH., PULS., PHOS.,BELL.,LYC.,MERC.,SIL., STRAM.

Differentiation of the remedies.

CALCAREA CARBONICA is fitting all symptoms perfectly well.

SULPHUR is warm remedy with hot feet, our patient is chilly with cold extremities. Sulfur doesn’t have fear of horror movies, he doesn’t like to be showered, it has some skin eruptions on and off and have aversion to eggs, different from our case.

PULSATILLA is clingy, easy crying, like affection, warm remedy with hot feet, which uncover at bed, same as SULFUR. And she doesn’t have fears as calcarea carbonica has.

PHOSPHORUS is chilly, friendly, smiling make easy contact with doctor, easily talk to people, our patient is shy and stubborn (his mom confirmed), which agree with CALCAREA CARB. PHOSPHORUS doesn’t have perspiration on occiput at night (no wet pillow), doesn’t have desire much for eggs, but has strong desire for sweets desire and even more strong fear of dark and has fear of thunderstorm. I asked his mother, he doesn’t have this fear. (According to his mother).

BELLADONNA is complementary to CALCAREA CARBONICA in treating acute. it is hot remedy, has desire lemonade, in fever may have delusion people around. Anyhow we are choosing now remedy for chronic condition. And Belladona is complimentary to CALC.CARB. We may use it for acutes for this boy in future.

LYCOPODIUM is cowards, thirst less, and has very strong desire for sweets, warm remedy. Has same fear of dark as well and fear of ghosts (not in our case). And aggravation at the same time (4-8pm) late afternoon to evening, like in our case. But no perspiration on occiput, no strong desire for eggs.

MERCURIUS SOLUBILIS is famous for severe tonsillitis and otitis media. But our patient doesn’t have salivation during sleep, yes, his pillow is wet, but from sweating, not from saliva. And he doesn’t have history of otitis media, nor desire for bread and butter, bleeding gums and smelly breath. Mercurius is syphilitic remedy, our patient doesn’t have such destructive symptoms, and he is more psoric.

SILICA is chilly and shy as well our boy, but no eggs desire. Can have sweaty head in sleep also, but usually have smelly perspiration on feet. Also stubborn, like our patient and dreams of being pursued by wild animals are often, like in our case. Has corrugated nails with white spots, which is missing in our case.

STRAMONIUM has strong fear of dark, sleep with light in his room, often in one bed with parents, because of fear to be alone. Has fear to be abandoned, fear of dogs, running water and stammering, like Mercurius sol., but it is absent in our case. And he is really very violent, wild. Our boy is quiet sensible, sleeps alone. And no perspiration on head at night and desire for eggs, in STRAMONIUM.

CALCAREA CARBONICA WAS CHOSEN, WITH POTENCY 10M IN 150 ml of water. And given 1 tablespoon every day 15 days.

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After treatment follow-up

First follow up after 3 weeks. He got mild cold with mild fever 38.5 Degree Celsius only, usually it is till 40 – 40.5c.

I advised to give him a lot of water, make gargling with warm salty water, and have a rest from school. After 3 days all symptoms subsides without treatment.

Second follow up after 2 months: He had a mild cold, with mild tonsillitis for 2 days, which was gone without treatment.

Follow up in 4 and 6 months: Boy is doing very well, no tonsillitis.

Follow up in 18 month: No complaint. No more fears.

His mother is very happy. She was planning for him tonsillectomy in India during vacation, in case my treatment was not successful. However, treatment was successful and no antibiotics, or paracetamol were given. The boy is doing well.