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Case Study

Whose sin is it?
Dr S Praveen Kumar

As the age old adage says "Nobody is cent percent perfect." We shouldn't be overconfident, nor adamant about our decision. This applies more to a doctor than any other professional as scores of lives are dependent on his decisions.
A reputed doctor was called in to examine and advise in a case of simple viral fever(?) in a lady aged 38 years . After examination, the attending doctor gave the diagnosis of urinary tract infection, even without any symptoms, and prescribed some Sulpha drug. in spite of following the instructions meticulously the lady didn't get relief; instead developed severe pricking pain in eyes, and also vomiting with severe nausea after 3 days. On inquiring the doctor prescribed one more drug for vomiting but the Sulpha drug was continued. After another two days she developed rashes with itching which slowly developed all over her body. On persistent questioning the doctor, it seems ,told her that she got "Eruptive fever" like pox and she did not need to worry . Yet he forced her to take the same drug.

With vexation, desperation and relentless suffering the patient was rushed to a private nursing home where it was promptly diagnosed as 'Sulfa induced Steven's Johnson Syndrome" and was started with immediate and appropriate treatment.

After 3 weeks stay at the Nursing Home she was left spots on skin, but severe dryness of eyes with swelling which didn't allow her to open them lest she gets severe pain. She consulted one renowned ophthalmologist and a famous eye Institute, where the same diagnosis was confirmed and she was told that there is no cure for it. She was using artificial tear drops every fifteen minutes.....

Stevens Johnson Syndrome is the severe type of Erythema Multiforme in which erythematous macules, or papules, wheals, vesicles, and sometimes bullae, or haemorrhagic lesions of the lips and oral mucosa, pharynx, anogenital region, and conjunctivae are there.

There is a high morbidity rate with an occasional death. The conjuctival lesions may be slowly followed by a slowly progressive intractable corneal shrivelling and atrophy, with loss of vision. There may be symptoms of urethritis in some patients.

It is frequently accompanied by malaise, polyarthralgia, and fever. Onset is usually sudden, at times preceded by an attack of herpes simplex, though the exact cause is not known. The drug sensitivity is common. To add fuel to the fire, there is a word of caution too 'Visceral malignancy must be ruled out, particularly in middle aged and older patients. These symptoms and lesions might last for 2, 3 weeks, or even longer, and may recur every year. There is no specific treatment but symptomatic relief in allopathic system of medicine.

The patient should be carefully managed with compresses, colloid baths, maintenance of adequate nutrition and electrolyte balance.

Homoeopathic treatment revolves mainly around Ars-alb, Apis- mel, Rhus- tox, Sulphur, Thuja, Crot- hor, Lachesis etc. besides the appropriate constitutional drugs.

For the lady in question Ars alb 200 followed by 0/3 in frequent doses helped a lot since 31/3/97. Now after fifteen days the lady does not use any tear drops nor even any other drugs. The spots on the skin are slowly fading off. The oral and pharyngeal lesions have healed to a great extent. She is able to open the eyes half and the vision is intact, there is no pain even.
Doesn't this raise a question in our mind - Whose sin is it?