Urticaria-like decompression illness in a caisson worker treated successfully in a monoplace chamber

Although decompression illness is rare for nondivers, it can happen in an environment involving rapid decompression. Recompression is the recommended treatment. We herein report a decompression illness case with cutis marmorata and osteonecrosis in both legs during pneumatic caisson work.

A 59-year-old compressed air worker suffered sudden dyspnea during pneumatic caisson work. He had rash on his trunk and limbs. He was diagnosed with decompression illness, and hyperbaric oxygen therapy was performed twice. He had no neurological dysfunction nor sequalae on discharge, but magnetic resonance imaging follow-up revealed osteonecrosis in both legs.

A detailed medical history should be taken when treating patients with dyspnea at work. Cutis marmorata often precedes more severe symptoms. Early introduction of hyperbaric oxygen therapy is desirable.