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A Case of Pyrexia of Unknown Origin


Homeopathic Journal :: Volume: 2, Issue: 1, Nov 2008 (Regulars)   -   from Homeorizon.com
Author : Dr. Krutik Shah, BHMS, MD (Hom)
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Article Updated: Oct 18, 2009


DETAILS OF THE CASE: -

A child 3 yrs old came to me with her parents. There was no problem till she was two years old. She is born with the normal delivery. She had a wt of 21/2 Kgs at birth and then it has increased steadily. She is suffering from cough on & off but no medicines have been given so far till now. This is mostly seen at the time of change of weather. 

She has some problem regarding speech. this started mostly at the same time with this fever problem. She is repeating some words like if she wants to speak "mummy" then she will do mmm....mmm...mummy. (+3). There is no specific word or time with which she has a problem. Some words she repeats up to 10 - 12 times... this also a problem for her but now we have observed that her style of speech has changed - now she takes a deep breadth and then speaks. 

She has a fever since last 10 months. It is coming every month between 10th - 15th date of every month (+3). Fever intensity is very severe. The body becomes so hot that we even cannot touch the body. We have observed that she might be playing well till the evening and as soon as night starts - her body starts getting heated up. fever till now, we have observed that it is coming in the nights (+3). We must do cold water massage on the body for the whole night & we use to give double dose of paracetamol syrup but still that fever does not go at all. Fever is crossing almost 104 F. Fever becomes absolutely normal in the day whether we give the medicine in the night or not! We are really having troublesome time with our child between 10th - 15th of every month. We have gone to three pediatric physicians and we have undergone almost all the relevant investigations including bone marrow biopsy, which is the highest level investigation and the diagnosis is still obscured!! All pediatric physicians are saying that your childCCC is suffering from "Pyrexia of Unknown Origin (P.U.O.)" we have spent minimum 15,000 Rs. for our child but still we have not been able to get her out of this problem. 

She also has a white discoloration on face (+2). These discolorations are more on cheeks. It was there in the past but it was almost cleared with anti-wormic treatment. Now it is coming back again. These are increasing day by day.

He is suffering from worms on & off and we have given treatment for it three times. 

She is also suffering from constipation. She has a hard stool (+3). She has to strain a lot.

She is suffering from little loose stool since last two days. She has a pain in abdomen and then she goes for the stool. She had some diarrhea at the time of dentition. At that time - we have taken Homeopathic treatment along with Calcium & Vitamin as a supplementation. 

She is by nature a very stubborn child (+2). She always does as per her wish. what ever do to convince her - she won't be doing. If you don't do as per her wish then she will go in the corner and cries constantly as long as she won't do as per her wish. She desires to travel very much. If you take her for traveling - then she will forget everything... even she won't demand to eat, drink, parents etc. When she goes to the bathroom she will take min. 30 minutes for her bath as she washes herself with soap so long that we sometime get offended upon her. she is regularly taking this much time. She knows everything where which things have been kept. Sometimes she tells us that Daddy..... you have put this thing here. She does her work own her own. Sometimes she helps me in my work like sweeping the room, cleaning the utensils etc.... She has a very high grasping power. Sometimes we even don't know a thing where we have kept it but she knows and tell that mummy it is been put there. She finds the cloths on her own what she wants to wear. She can match her cloths well. Even the ring for her hair she matches as per her cloths, own her own. She wants to speak constantly. She picks up a word from our talk and speaks or sings upon it which is her regular habit. She speak min. up to 5 min. upon that topic and then her mind gets diverted and then she forgets about it. She is very cute child as she very mischievous at home and she is quiet outside. She doesn't love toys much. She can speak from 1 to 30, A to Z & Jan to Dec. even though she is just 3 years old. She is very curious for her studies; she says to her parents that I need to study. She does all her home work perfectly well. 

She has no problem regarding food. she eats everything. She has no like/ no dislike for any food. One thing I forgot to tell you is that she likes milk (+2). But it is dependant upon her mood..... if she has taken it at 8 o' clock then she may demand for it at 10 o' clock. She does not take much but she takes it regularly. 

Appettite: - Good.

She cannot tolerate hunger, if she is hungry then she won't be able to wait for half an hour! When she was two years old - she was regularly waking up in the night and wanted to eat in night - she can go to the kitchen and eat on her own alone!! She has no fear what so ever. 

Thirst: - Very much. (+3) 

Urine: - Normal. No bed wetting. 

Stool: - Constipated. has to strain a lot.

Desire/Aversion: - D: Banana (+2)

                         D: Ice cream (+2)

                         A: Not Specific. 

Hot/Chilly: - Hot (+3). 

Perspiratin: - Very much.

                    Perspiration on neck and sholders during sleep (+2).

                    Talking during sleep (+2). 

Sleep: - Good.

             No fixed Position.           

Vaccination: - Done. No after effects. 

Mile Stones: - Normal.  

FAMILY HISTORY: - 

Father: NAD.

Mother: - Ganglion Wrist, on my treatment.

PAST HISTORY: - No other data found other then what is explained.

GENERAL EXAMINATION: -

Built: - Good.

Nutrition: - Good.

Nails: - NAD.

Tongue: - White coated.

Mouth: - NAD.

SYSTEMIC EXAMINATION: -

RS: - NAD

CVS: - NAD

P/A: - NAD

CNS: -  Clinically Normal.

BIRTH HISTORY: -  Not Specific

NOTE: - The case was taken on 11-5-06, which happened to be the first case of my clinic as I inaugurated it on 9-5-06. I had observed that child was very silent during the whole process of case taking, her mother has given maximum information about him.

As I always write the whole case in the words of the patient - I have quoted almost all the symptoms. Acc. to me, Underlining or intensification of symptoms of the symptoms are made with much care & with cross-examination. Symptoms written with no intensity are of no value.

Address of the patient can be provided on requirement.

A case of a 3 years old child suffering from Pyrexia of Unknown Origin (P.U.O.) came to me where almost all her details were told by her parents. The case has been taken it the Gujarati, in our local language and has been translated in to English by the physician.

Homeopathy shines in this case very well as it was been not treated by two well-known pediatricians as there was no cause. Application of Organon is still hold true even after 250 years!! (See Comments).

REPERTORIZATION CHART: -

Repertorisation has been done in the synthesis repertory 9.2.Version (Creator Dr.Frederik Schroyens, Belgium) of RADAR Homeopathic software. It is been checked by flat repertorisation as well as with the help of Vithoulkas Expert System (VES). After forming the totality with analysis & Evaluation, total 16 rubrics have been taken.

PRESCRIPTON: - Sulphur 200/one dose

                          S.L. B.D.S. for a week.

F/U: - 1.

Date: 16-5-06

                   Fever Low grade.

                   Feel better.

                   (Comment: remedy has acted as the child did not develop fever, which uses to come between 10th - 15th of every month.)

 Treatment: - S.L. BDS for a week.

 F/U: - 2.     

Date: 21-5-06

                   No major complaint.

                   Cough +. Not that much.

(Comment: Initially it use to be at the change of weather - it has developed after the remedy which is a sign of that now remedy is helping the organism to eliminate toxins from the body.)

Treatment: - S.L. BDS for a week.

 F/U: - 3.

Date: 29-5-06.

No major complaint.

No cough. It got subsided on its own.

(Comment: Confirmatory sign of elimination of Toxins. Dr.Samual Hahnemann has written that there are four methods of elimination of toxins from the body: - Perspiration, Urination, Defecation & Respiration.)

Treatment: - S.L. BDS for a week.

F/U: - 4.

Date: 6-6-06.

No major Complaints.

No Cough.

Treatment: - S.L. BDS for a week.

F/U: - 5.

Date: 11-6-06.

No fever.

No Major Complaints.

 Treatment: - S.L. BDS for a week.

 F/U: - 6.

Date: 19-6-06.

No fever.

No Major Complaints.

Treatment: - S.L. BDS for a 2 weeks.

 F/U: - 7.

Date: 1-7-06.

No fever.

No Major Complaints.

 Treatment: - S.L. BDS for a 2 weeks.

 F/U: - 8.

Date: 19-7-06.

No fever.

No Major Complaints.

Treatment: - S.L. BDS for a 2 weeks.

 Now, as there was no fever since the start of the medication - it is a clear sign that the medicine has acted and it has almost cleared the problem. Now the child is advised to be observed for a 2 month.

 F/U: - 9.

Date: 4-8-06.

No fever.

No Major Complaints.

 Treatment: - No medicine given.

 F/U: - 10.

Date: 24-8-06.

No fever.

No Major Complaints.

 Treatment: - No medicine given. 

          The child is been advised to leave the treatment as she declared cured from the Pyrexia of Unknown Origin (P.U.O.). She is been advised to consult the same pediatrician who has diagnosed her. Now, the same pediatrician has said that the child is been cured!!

COMMENT: - There was no clear remedy picture in the case. This case is been treated with a single medicine. This is a classical case of Intermittent Fever, But according to Organon.. The indicated remedy should be given in the decline phase or during a febrile sate, but due to mistake - I gave it at the beginning of an intermittent fever. However, luckily - it didn't acted on the opposite way (Aggravation) but it has cut short the time, intensity as well as suffering of the patient. 

We don't treat disease; we treat patient of the disease. Modern Medicine diagnose them with the name of the disease while Homeopathy diagnose them with the name of the remedy. Symptoms are the outward reflection of the internal derangements; thus we are not supposed to treat outward reflection but we are supposed to treat internal derangement. Symptoms are the epileptic feet of an organism seeking attention for the help. They are merely a manifestation of the unique way that the defense mechanism is attempting to maintain the balance. As body is made up from one cell - whatever symptoms appear on the different parts of the body are scientifically interconnected. Thus taking a case from top to bottom, as a whole will be helpful for the final selection of the medicine. With this holistic approach - patient may suffer from one disease or 10 diseases but everything will go with one stroke. This was been said by Dr.Hahnemann 250 years ago and today it is still hold true!! 

Here, I would like to let you know that Dr.Hahnemann, in his Organon of Medicine ( 5th & 6th Edition), in Aphorism 242, says that "We have now to do with a psoric intermittent fever only, and this will generally be subdued by a minute and rarely repeated doses of Sulphur or Hepar Sulphuris in a high potency." 

This aphorism ultimately helped me and cleared my case.


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a good description about the PUO AND ITS MANAGEMENT.Actual problems and homeo treatment.
  Comment by: Dr.paul murugan, India.    on Mar 17, 2014 0 Agree  |  0 Disagree       Report Abuse

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