2011 July August

A case of chronic osteomyelitis with Brodie's abscess

by Jean-Pierre Jansen

osteomyelitisThe patient is a boy in early puberty. His complaints started 3 years ago in a foot; later a dissemination (Brodie's abscess) occurred to the pelvic bones. There were several exacerbations per year, which were treated with long courses of antibiotics. He improved with each course of antibiotics but the inflammation-free intervals became shorter and shorter. The last relapse started one week after the end of a course of antibiotics of a few months duration. The situation became almost intractable because of the pain and the general well-being of the patient. The surgeon planned a removal of a part of the pelvis, a very mutilating operation, should another exacerbation follow.

We could not find a clear causation for his complaints. He is worse if his immune system is down during busy times at school.

Physical complaints:

- Swelling of the feet and tibia, worse during warm weather.

- Aggravation of pain and swelling, with fever during the evening and night.

- Stitching pains aggravated from exertion of the limb. He cannot find a pain-free resting position, so he wakes from pain, and the resulting lack of sleep worsens his condition.

- Difficulty in falling asleep. He does not feel sleepy and his parents describe him as a night person.

- He is generally better from massage.

Psychological:

He is a dreamy type of person, always having fantasies of what he would do after school-time. He loves reading scientific books and dictionaries and he is very interested in airplanes and aviation. Sports are important to him but he cannot participate in them anymore. He cannot stand horror movies and has a fear of high places. He has an aversion to tight clothing and must loosen his trousers. He prefers company.

tomato soupFood:

Aversion to warm food, bread, and vegetables. Desires strawberries. His desire for tomato soup, to the exclusion of all other food, when he is unwell is particularly worth noticing.

Analysis:

The strange and peculiar symptom is his desire for tomato soup. Although this is not noted as such in the repertory, Calcarea arsenicosa is in capitals in the rubric 'Desire soup' in my repertory: the Complete Dynamics v3.1. The other remedies in that rubric did not make sense in this case, and I considered the necrosis of the bones as a confirmation for both components of the salt Calcarea arsenicosa. Interestingly, the remedy has also the symptom 'fear of birds', which could in a paradoxical way confirm his interest in aviation. I noted Stillingia as a second choice.

Prescription: Calcarea arsenicosa 200K

Follow-ups:

After taking one globule, he had a lot of pain in his foot for one week. A week later, his sedimentation rate had normalised; he still had a lot of pain but generally felt better. After 5 months, the X-rays showed no sign of the previous damage.

I instructed him to repeat the remedy as soon as he felt an aggravation somewhere in his bones. He gradually improved and was declared healthy after 15 months and 13 repetitions of the 200K. He mentioned that he felt relief within a few hours after each dose. This encouraged us to continue. A year later, he played football, as if nothing had happened.

Photos: Wikimedia Commons
Tomato soup; Eksimaru
Osteomyelitis of the tibia of a young child showing numerous abscesses in the bone as radiolucency; Sarindam7

 

 

Categories: Cases
Keywords: chronic osteomyelitis, Brodie's abscess, desire tomato soup, sleeping difficulties
Remedies: Calcarea arsenicosa

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Posts: 3
Comment
ASD?
Reply #3 on : Fri April 12, 2013, 14:21:40
Dear Madeleine,
the boy had no psychiatric problems, in fact he was beloved by his mates in the football team, who supported him during his disease episodes. From what I heard nobody really had problems interacting with him. Therefore the DD ASD never came up, although I have directed my anamnesis to detect it.
Anyway, I didn't know that tomatosoup is a typical desire in ASD. Thanks.

Posts: 3
Comment
Re:
Reply #2 on : Fri April 12, 2013, 10:00:00
Dear Jean Pierre,
besides being pleased about the treatment result for the boy, the description of the boy caught my attention. The information regarding psychological, food and the sleep disorder are typical for persons with autism-spectrum disorders. From this perspective his desire for tomato soup is not peculiar at all.

Posts: 3
Comment
Case of Brodies abscess
Reply #1 on : Sun July 03, 2011, 10:40:16
Hello Jean Pierre Jansen,
After a long time it is nice to read a case of wonderful way of treatment by you.
Thank you,
Greetings,
Chetna Shukla

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