Dr Shweta Goyal
Abstract- Case of a lady of 36 has complained recurrent episodes of urinary tract infection with frequent admissions in hospital. She was experiencing severe pain in lower abdomen with fever since 4 years. Her ultrasound reports showed pelvic inflammatory infection. After taking her complete case history, she was given Natrum muriaticum. She recovered beautifully with single dose of Homoeopathy.
Introduction- Pelvic inflammatory disease is characterized by inflammation and infection arising from the endocervix leading to endometritis, salpingitis, oophoritis, pelvic peritonitis and subsequently formation of tubo-ovarian and pelvic abscesses. Chlamydial and gonococcal infections are commonly implicated, however, other organisms, such as bacterial vaginosis, may be identified.
Once the infection has ascended to the upper genital tract, the Fallopian tubes are commonly damaged. There is the inflammation of the mucosal lining which, if progressive, will destroy the cilia within the Fallopian tube followed by scarring in the tubal lumen. This can cause pocketing within the lumen with partial obstruction and thus predispose to ectopic pregnancy.
Signs and symptoms
- Abdominal, pelvic pain and dyspareunia
- Muco-purulent vaginal discharge
- Pyrexia (>30degree Celsius)
- Heavy/intermenstural bleeding
Diagnosis
Based on clinical findings:
- Raised white cell blood count (neutophilia suggestive of acute inflammatory process )
- Reduced white cell count (neutropenia in severe infections)
- Raised C reactive protine and ESR (erythrocyte sedimentation rate)
- Adnexal masses on ultrasound
- Laproscopy is the gold standard to give a definitive diagnosis.
Case report
Patient complained of severe pain in lower abdomen with fever since 4 years. The pain aggravated when standing and lifting heavy weight. She also suffered from discharge per vagina, it was transparent, thick, and was more before menses.
History of present illness-
Patient had taken medical kit 4 years ago and did not rest for a month after taking the kit. After this, she developed severe pain in lower abdomen and fever. Since then she is suffering from burning during urination, ineffectual urging to urinate every month.
Treatment history–
She took antibiotics for fever and UTI for 4 years as recommended by different doctors. But after prolonged use of antibiotics, she became sensitive to antibiotics. Now she vomits after taking any allopathic medicine. She has been admitted to hospital quite frequently where she is given antibiotics and painkillers via injections but with partial relief. She also suffered from excessive hair fall.
Physical generals–
Patient suffered from frequent urging to urinate, urine was scanty (ineffectual urging). She could not pass urine in presence of anyone, not even her husband, she would control it. She was constipated. Her abdomen was hard on palpation. Her sleep was disturbed due to frequent urging to urinate. She had desire for salt.
Menstrual history–
Her menses were regular with 33 days cycle, duration of 4-5 days, flow scanty, color dark. She had pain in thighs during menses.
Weight- 77.6 kgs
Mental generals–
She did want to talk in anger. She had fear of narrow places like lift. Patient also had fear of crowded places like she could not go to fairs. She felt anxious when exposed to sun for long period.
Laboratory findings and investigations–
Ultrasound report showed PID with thick wall urinary bladder.
Repertorisation–
Diagnosis-
Pelvic Inflammatory Disease
Prescription-
Natrum mur 200 1 dose
Follow up –
Pain got better within a day. Weakness got better in next 20 days. Leucorrhoea was better. Hair fall decreased in 2 months.
After the completion of treatment, Ultrasound report came out to be normal. Patient never complained of pain lower abdomen after single dose of natrum mur.
Patient 36/F
Dr. Shweta Goyal
B.H.M.S (Gold Medalist)
MD Part-1 (Hom) Materia Medica
Sri Guru Nanak Dev Homoeopathic Medical College, Ludhiana
PG (IACH) Greece
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