Dr Rajendra Patil
Impetigo is a highly contagious infection of the epidermis, seen especially among children, and transmitted through direct contact. Over 140 million people are suffering from impetigo at each time point and approximately 100 million are children. It is type of bacterial diseases which is highly contagious and spread from close contacts. Most common bacteria are staphylococcus aureus and Group A streptococcus impetigo exits in two forms of, namely impetigo contagious which is also known as the non-bullous form and the second one being bullous impetigo which presents with large and fragile bullae.
KEYWORDS: Impetigo, Homeopathy, Staphylococcus. Streptococcus
Impetigo is common & a highly contagious superficial bacterial infection of the skin caused most often by S. aureus & in some cases by group A beta- hemolytic streptococci. The primary lesion is superficial pustules that ruptures & forms a characteristics yellow brown honey- colored crust. Lesions may occur on normal skin- primary infection or in areas already affected by another skin disease- secondary infection.1 Two main presentation : bullous impetigo, caused by staphylococcal epidermolytic toxin & non – bullous impetigo, which can be caused by either staphylococcal or streptococci or both together. All ages can be affected but non- bullous disease particularly affects young children, often in late summer. Outbreaks can arise in conditions of overcrowding & poor hygiene or in institutions and transmitted through direct contact.2
The prevalence of impetigo is worldwide. Over 140 million people are suffering from impetigo and approximately 100 millions are children.3
Lessions caused by staphylococci may be tense, clear bullae, & this less common form of the disease is called bullous impetigo. In non- bullous impetigo, a thin-walled vesicle develops: it rapidly ruptures & is rarely seen intact. 1,2
CASE REPORT :
CASE 1 : C. R No – 220921459 D. R No – P222
A 4 years old child patient reported to outdoor patient department with painless eruptions around corner of mouth since month with a history of peri-oral lesions and low grade fever. Child developed painless eruption around of mouth few days back. Initially he took other system of medicine but no relief. However lesions progressed without any resolution. He also developed crustations and multiple small vesicles which rupture spontaneously.Oral examination showed multiple peri oral crusting. The crusting was also surrounded by red, raw skin with ragged edges. Intra oral examination shows nothing significant. Diagnosis of impetigo is made on the basis of clinical examination and presentation.
Past History- nothing significant found.
Medicinal History– treated with antibiotics and topical ointment for this problem.
Family History– nothing significant found.
Vaccination History– Properly scheduled.
Appetite- Decreased, only half chapatti twice a day a
Thirst- 1-2 glass per day, thirst less
Desire- sweets+++ as per his mother
Aversion- not specific
Stool- Regular, once daily, soft and easily evacuated
Urine- 4-5 times/day
Perspiration- profuse, sour++
Mental Generals– According to his mother child is very much aggressive and destructive. He used to break things. The most important observation was made regarding his nature always serious looking child, which was also confirmed by his mother. He also used to hit his fellow friends during play. His behavior is very rude. He is also hasty in speech.
REPERTORY USED : KENT’S REPERTORY
- Mind : speech hasty
- Mind Anger, irascibility: violent
- Perspiration, odour : sour
- Face eruptions: Impetigo
- Hepar- 11/4
- Lyco – 8/4
- Merc- 8/3
As per the totality of case and knowing the disposition of patient Hep.sulph 200 single dose was prescribed followed by placebo for 7 days. After one week she was followed up. In 2nd follow up her eruptions were totally disappeared with improvement of general.
CASE 2 : C. R No – 220921460 DR No – 1M5011
A 18 year old male presented with rapidly spreading lesions on the face & nose & a crack on the right nostril. The lesion seemed to be impetigo. This occurred after swimming in a pool. In only one day, the right nostril was completely blocked with honey colored crusts, which became hard- like stones, with pus discharging from the skin.
REPERTORY USED : KENT’S REPERTORY
- Nose-cracks in nostrils
- Eruption nose, inside right nostril
- Face, eruption: impetigo
REPETORIAL ANALYSIS :
- Anti crud – 4/2
- Sulphur – 4/2
- Nit acid – 3/2
PRESCRIPTION : 3 dose of Anti crud 30c was given, with Placebo for 7days, where the next morning all small crusts disappeared from nose, face & the large started bleeding. Later after 7days a single dose of Anti crud 200 was prescribed & completely the lesions got healed.
Impetigo is a highly contagious infection, direct contact being the main mode of transmission. Patients with impetigo can easily inoculate themselves and spread the infection to people in close contact after excoriating an infected area. This fact may lead to a rapid dissemination of infection, mostly in grade schools, kindergartens, nurseries and day care centers. It is known today that children usually become infected through contact with other children; however fomites are another important source of infection. Adults may develop impetigo from contact with children or by fomites as seen when sharing grooming devices, in barber shops, in beauty parlors etc. Conventional system of medicine uses antibiotics and topical corticosteroids for treatment, which generally having side effects. Homoeopathic system of treatment treats the patient in a holistic way without any side effects.
From this study it can be stated that Individualised Homoeopathic medicines can cure such cases of bacterial infections where the cases presenting with Prominent generals or Characteristic particulars.Though it is a contagious infection but through Constitution prescription we can reduce the recurrence.
- Stuart H. Ralston, Ian D. Penman, Mark W.J. Strachan, Richard P. Hobson . Davidsons Principles & Practice Of Medicine- 23rd e/d. Elsevier 2018.p. 236
- Longo, Fauci, Kasper, Hauser, Jameson, Loscalzo. Harrisons Principles of Internal Medicine 18th, USA: Mc Graw Hill Company.p.401-403
- Parthasarathy A. IAP Textbook of pediatrics. Ed 6. New Delhi: Jaypee Publishers 2012.p.1142
- Kent J.T.Repertory of the Homoeopathic material medica.New Delhi:6th e/d B Jain Publisher
Dr Rajendra Patil.MD (Hom)
Department of Practice of Medicine
HKES’s Dr Maalakaraddy Homoeopathic Medical College & Hospital
Mahadevappa Rampure Marg, Kalaburagi 585101