1. A 2 year old boy with Acute Otitis Media – Case Presentation

2. Nilanjana Basu, Homoeopathic Physician Sameer Rana E.N.T. Specialist,
Lecturer, Department of Surgery
Sameer Rana E.N.T. Specialist,
Professor, Department of Surgery
Bakson Homoeopathic Medical College,
Greater Noida
Correspondence to :

3. Registration no /09
Age/Sex – 2years/Male
Residence – Gamma 1,Greater Noida

4. Chief Complaints
Recurrent nasal discharge and stuffiness since 1 ½ months
Itching in left ear since 10 days

5. History of presenting illness
2 year old baby brought to the E.N.T. clinic on with recurrent nasal symptom of cold, stuffiness and rhinorrhoea since 11/2months.
His mother complained 2 weeks back of an episode of left earache followed by discharge which was profuse and mucoid. Pain was severe at the middle of the night due to which he couldn’t sleep.

6. History of hearing loss was not forthcoming
History of hearing loss was not forthcoming. For the above complaints antibiotic and decongestant treatment was given by a local practitioner for 10days. At the time of case taking patient only had nasal complaints and itching in the left ear general irritability.

7. Past history
Patient had recurrent attacks of Upper respiratory tract infections

8. Family history Mother – alive – Susceptibility to cold
Father - alive- Healthy

9. General physical examination
Mental state & conciousness-Well oriented & fully concious
Built & Nutrition – well built
Facies – normal
Pallor – absent
Icterus – absent

10. Cyanosis – absent
Oedema – absent
Clubbing – absent
Temperature – normal
Pulse – 100/min
Respiration – 20/min

11. Examination of Head & Neck
EAR –
Bilaterally pinna normal, excoriation of the skin and external canal on left side. External canal of Right side was normal. Left tympanic membrane congested with a small central perforation. Right tympanic membrane appeared normal. Patient did not respond to Tuning fork test. Facial nerve was normal bilaterally and there was no nystagmus.

12. NOSE
Bilaterally muco-purulent discharge with pallor and oedema of turbinates.
THROAT – normal
EXAMINATION OF NECK – normal

13. Otoscopic examination
Left tympanic membrane congested with a small central perforation.

14. Summary of the case:
A 2 year old boy presented with itching of left ear since 10 days. He had h/o upper respiratory tract infection since 1 ½ months followed by an episode of left earache followed by discharge which was profuse and mucoid 2 weeks ago. Pain was severe at the middle of the night due to which he couldn’t sleep.

15. On examination the left tympanic membrane was congested with a small central perforation. The right ear was normal.

16. Diagnosis
Acute Otitis Media of left Ear

17. Rubric selection
The patient was irritable, restless, had itching in left ear at night. The rubrics selected likewise were from Kent Repertory.
Mind, restless, nervousness, night
Mind, irritability
Ear, itching in, left
Generalities, night

18. 4145/09

19. Prescription
All the rubrics covered Rhustox, which was prescribed in 0/1 potency thrice a day.
Ear was regularly cleaned.

20. Follow up
After 7 days the baby’s nasal discharge decreased, irritability, restlessness and itching in ear were relieved. The medicine was continued for another 15 days.

21. Rhustox 0/2 was prescribed on 20. 10. 09
Rhustox 0/2 was prescribed on The ear was dry but the perforation started healing. The same medicine was continued for 7 more days. On the ear was examined with an otoscope which revealed that the perforation was healed.

22. Discussions
The importance of healing this perforation is utmost as the recurrent attacks of cough and cold complicates the perforation and it becomes chronic otitis media with hearing loss and discharging ear.

23. This age also coincide with the development of speech
This age also coincide with the development of speech. If the patient cannot hear there will be improper development of speech.

24. Rhustox was given on account of the restlessness of the baby at night which was very marked.
Fifty millesimal potency was prescribed as we required frequent repetition of the medicines in ever increasing dose.