Paper Title
A Diagnostic Challenge of a Recurrent Lumbar Abdominal Swelling: A CARE-Aligned Case Report with Individualized Homoeopathic Case Analysis
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Registration ID: IJNRD_328663
Published ID: IJNRD2609270
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Keywords
Keywords: Abscess; granuloma; recurrent cutaneous swelling; individualized homoeopathy; Calcarea sulphurica; photographic follow-up; case report.
Abstract
Background: Recurrent painful or tender cutaneous swellings may present a diagnostic challenge when classical clinical features such as fluctuation are absent. Differentiation between an abscess, granulomatous lesion, inflamed cyst, cellulitis, or other localized soft-tissue lesion may require serial clinical assessment and, where indicated, appropriate diagnostic investigations. This case describes a recurrent localized swelling in the left lumbar abdominal region with a previous history of hard boils and draining cutaneous lesions. Case Presentation: The patient presented with a three-day history of swelling over the left lumbar abdominal quadrant associated with burning and pricking pain. Clinical examination revealed a hard, firm swelling measuring approximately 5–6 cm × 3–4 cm, with irregular margins and surface, local warmth and tenderness, and redness predominantly at the tip. Fluctuation was not elicited. The patient also reported previous recurrent hard boils and smaller eruptions involving the lumbar region, inner thighs, and genital region, some of which had been drained and healed with scar formation. The individualizing symptom picture included a hot thermal state, thirst, unrefreshing sleep with increased sleep requirement, easy forgetfulness, brooding over perceived problems, timidity, desire for appreciation, feelings of neglect and humiliation, sensitivity to comparison, and quarrelsomeness. The principal clinical differential diagnoses included abscess and granulomatous lesion, while other localized soft-tissue conditions, including recurrent follicular/occlusive disorders, were also considered. Intervention: An individualized homoeopathic prescription of Calcarea sulphurica 200CH was administered as a single dose, with a total of two doses during the documented treatment period. The second administration was made on 11 July 2026 following reappearance of the purulent point. Remedy selection was based on the totality of characteristic mental, constitutional, and local symptoms rather than solely on the clinical diagnosis of the lesion. Outcome: Serial photographic follow-up documented progressive changes in the lesion. From the baseline photograph, the lesion remained raised and tense during 19–22 June 2026. On 22 June, the source record described the lesion as approximately half its previous size while remaining hard, followed by spontaneous semisolid drainage. Between 22 and 28 June, photographs documented drainage/opening followed by progressive reduction and healing. By 30 June–2 July, the lesion appeared substantially smaller, with a small residual lesion documented. On 9 July, recurrence was recorded as “TIP OF PUS?” with a new raised/pustular point. Following repetition of the prescription on 11 July, the photographs dated 11 and 19 July showed a flatter residual area with discoloration compared with the earlier raised and draining stages. Conclusion: This case demonstrates the value of chronological photographic documentation in recording changes in a recurrent localized cutaneous lesion during individualized homoeopathic management. The case also highlights the diagnostic uncertainty associated with a firm swelling without classical fluctuation and the importance of appropriate clinical evaluation when abscess, deep infection, granulomatous disease, or other structural lesions remain possible.
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How To Cite (APA)
Dr. Shridevi Siddineni, Dr. Chitram Umashankar, 3. Dr. Banoth Pradeep, & Dr. Pothoju Jhansinisivamani (September-2026). A Diagnostic Challenge of a Recurrent Lumbar Abdominal Swelling: A CARE-Aligned Case Report with Individualized Homoeopathic Case Analysis. INTERNATIONAL JOURNAL OF NOVEL RESEARCH AND DEVELOPMENT, 11(9), c699-c718. https://ijnrd.org/papers/IJNRD2609270.pdf
Issue
Volume 11 Issue 9, September-2026
Pages : c699-c718
Other Publication Details
Paper Reg. ID: IJNRD_328663
Published Paper Id: IJNRD2609270
Research Area: Medical Science All
Author Type: Indian Author
Country: Hyderabad, Telangana, India
Published Paper PDF: https://ijnrd.org/papers/IJNRD2609270.pdf
Published Paper URL: https://ijnrd.org/viewpaperforall?paper=IJNRD2609270
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