Invasive bacterial disease, part 3 - Sepsis/Bacteremia
Sepsis/Bacteremia
One of the most concerning problems in pediatric practice is bacteremia, which may present primarily, or may complicate pneumonia or meningitis, involving a range of potential pathogens, including Streptococcus pneumoniae and Hemophilus influenzae (type b & other encapsulated serotypes, as well as non-typable strains).
Presentation is as a fever of unknown origin, often initially suspected to be acute otitis media (the most common acute febrile presentation in young children). There’s a metric of “sick” presentation that requires some clinical experience to recognize, that involves the characteristic unique mix of lethargic irritability in fever that I mentioned in my discussion of meningitis. Careful history, examination, & urinalysis is required to rule out a focal infection (acute otitis media, urinary tract infection, pharyngitis, pneumonia, meningitis). Blood drawn for white blood cell count & differential, and for culture & sensitivity, confirms the diagnosis.
Hospital management is necessary, with outcome dependent on early recognition & treatment. IV ceftriaxone, vancomycin, or cefepime are often begun empirically until culture & sensitivity on samples obtained prior to the initiation of antibiotics refine antibiotic selection. IV hydration is necessary, along with careful observation.
A broken record here, but once again, with added emphasis, there is no rationale or evidence to consider antibiotics to be “suppressive” or to “antidote” or otherwise interfere with homeopathic treatment, or v/v. There is a legitimate, and often necessary, role of antibiotics in treating some of these diseases. Homeopathy addresses the disease, antibiotics address the continuing morbific influence responsible for the disease. Both have a legitimate role here. It would be tragic if homeopathic myths interfered with the use of antibiotics in bacteremia or in other serious bacterial disease. As homeopaths, we can treat alongside antibiotics with no fear of interference in either direction.
If we do have the “opportunity” to treat bacteremic sepsis homeopathically, it will be as an adjunct to hospital-based conventional management. Any delay in assessment and initiation of antibiotic therapy is to the child’s detriment. The observation that Constantine Hering, Adolf Lippe, & their colleagues often were able to treat pediatric sepsis prior to the advent of antibiotics need not embolden us to abandon one of the truly useful tools of conventional practice. Last I looked, I was not Adolf Lippe. It’ll hopefully be a while before I can discuss this with Adolph directly, but I suspect he’d agree.
