Decompression sickness responsive to delayed treatment with hyperbaric oxygen: a case report of two divers

With the increasing popularity of recreational scuba diving, rare complications are becoming more commonly encountered. Although diving is generally safe, novice divers may be unfamiliar with the potential hazards of scuba diving and the resulting sequelae. Dive-related injuries are commonly due to barotrauma or from breathing gas at increased pressures, resulting in decompression illness (DCI), a term that includes both decompression sickness (DCS) and arterial gas embolism (AGE). Symptoms can range from minor aches and pains to neurologic or cardiopulmonary complications resulting in death. Clinical symptoms and diagnosis may initially go unrecognized and can present in a delayed manner, often remote to the diving location. When DCI is suspected standard treatment with hyperbaric oxygen (HBO2) therapy should be considered immediately. Current literature questions the efficacy of delayed HBO2 therapy longer than 24-48 hours after symptom onset. Here we present a case of two divers who simultaneously experienced DCS and were both successfully treated after receiving delayed HBO2 therapy nearly eight days after initiation of symptoms.