Impact of Individualized Homoeopathic Medicine on the Treatment of Otomycosis in Pediatric Patients: A Case Report

Abstract – Otomycosis is a common superficial fungal infection of the external auditory canal (EAC), often presenting in acute, subacute, or chronic forms. While usually unilateral, it can be bilateral in immunocompromised patients. This article discusses the case of a 10-year-old male who presented to the outpatient department of Bakson Homoeopathic Medical College and Hospital with severe ear aches, and itching in his left ear. After the case assessment, he was prescribed MERCURIUS SOLUBILIS 200C based on individualization. The article emphasizes the effectiveness of homeopathy in managing and preventing the recurrence of fungal infections, providing an alternative mode of treatment as an option.

Keywords – Otomycosis, minimum dose, MERCURIES SOLUBILIS, homeopathic management 

Introduction –Otomycosis is a superficial fungal infection of the external ear canal, prevalent in tropical countries. Symptoms include itching, ear pain, hearing loss, and foul discharge, which can worsen with manipulation of the ear canal. It often affects individuals with a history of antibiotic use for bacterial otitis externa, those with pre-existing inflammatory ear conditions like eczema or psoriasis, and those involved in aquatic sports. Ear infections can occur when the Eustachian tube, which connects the throat to the middle ear, becomes blocked by mucus or fluid, leading to pressure, pain, and a red, bulging eardrum. Ear symptoms can come on quickly. 

Children can show different signs of ear pain than adults. If the child can’t communicate their discomfort, watch for specific symptoms based on their age.

• – Worsening ear pain when lying down  
• – Tugging at the ear  
• – Difficulty sleeping  
• – Trouble hearing  
• – Fever above 100°F  
• – Ear drainage  
• – Headache  
• – Loss of appetite   

Conventional treatment targets fungal infections with topical drops and immunosuppressive medications. However, frequent use can lead to dependency and may weaken the immune system in growing children.

Case History–A 10-year-old male patient presented to the OPD with recurrent left earache and severe itching that began four days ago, accompanied by a cold.

Key Aspects of Pain – Recurrence – Regular Episodes

• Onset – gradual
• Nature – excruciating pain 
• Extension -towards the left ear side  

Modalities—His complaints aggravate every time there is a change of weather, dust, or night. Amelioration from motion. The itching aggravates at night and when bathing. He took antipathic medicine for a few months with only transient relief, following which the complaints aggravated.

History of Patient’s Illness-

The patient was in good health until one year ago when he developed a boil in the left ear canal. After being slapped by his older sister, the boil ruptured, causing pus drainage. His mother promptly cleaned the area and applied mustard oil to alleviate the pain. Two days later, he began experiencing significant earache accompanied by mild discharge and intense itching. The discharge was scanty, transparent, watery, and non-offensive. Since that incident, he has consistently faced recurrent earaches and itching. He has effectively used allopathic topical drops and mustard oil whenever necessary to manage these symptoms.

• H/O of Recurrent cold 
• H/O of Itching was present he used a pencil to scratch the external auditory canal 
• H/O of topical use, mustard oil to reduce the pain 

Treatment history – The patient took allopathic treatment for his complaints; he felt better after the treatment but after some time again his complaints started even in the worst form. After that treatment, the patient develops earaches again of the same intensity or worse day by day. 

Past History – The patient has had low immunity since childhood. He had suffered from recurrent throat infections like recurrent tonsilitis in childhood. 

Family history – Nothing significant 

Physical generals 

Mental generals – Irritable and timid, this person is shy and prefers minimal conversation. He babbles, fears others, and experiences sudden, impulsive anger that leads to throwing and destroying their favorite items.

General Examination –

BUILT- lean, 

HEIGHT- 3’2”

WEIGHT- 27kg

VITALS

TEMPERATURE– Afebrile

PULSE– 84 beats/min

RESPIRATORY RATE– 18 breaths/min

BP– 90/72 mmHg

LYMPHADENOPATHY–  Parotid  & Submandibular lymph nodes on both sides, 

NOSE

Inspection of the nasal cavity

Nasal septum- deviated to the left side

Inferior turbinate’s inflamed, bilaterally seen 

THROAT

TONSILS: enlarge both sides

TUNING FORK TEST

    RIGHT EAR             LEFT EAR 

               +                W +

Normal   ABC Normal

OTOSCOPIC EXAMINATION – Normal tympanic membrane seen, cone of light is not visible.

IMAGE 1– A thin, transparent, network-like appearance marked the initial approach to the case.

IMAGE 2 -The discharge manifested a wet, paper-like appearance with a distinct yellowish-green color.