Oxygen Toxıcıty After Hyperbarıc Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) involves breathing 100% oxygen intermittently in a chamber (either mono- or multiplace chamber) at a pressure greater than one atmosphere absolute (1 ATA). Osteomyelitis of the maxilla is very rare due to the high vasculature of this bone. Hyperbaric oxygen therapy is used in the treatment of refractory osteomyelitis. A 24-year-old female received HBOT for treatment of chronic osteomyelitis maxilla. On the 13th day of HBOT she had twitching of her fingers, nausea/headache, blurred vision, and anxiety. Her cutaneous axillary temperature was 40.6 °C. Her pulse was 80/minute and blood pressure was 110/70. In her examination confusion and facial pallor were remarkable. After laboratory samples were taken conservative therapy including intravenous hydration, metamizole sodium, and peripheral cooling was given. In an hour her neurological symptoms had improved and her fever normalized. As all blood tests were normal, septic fever was ruled out. Based on the peripheral vasoconstriction, facial pallor, neurological symptoms, and hyperthermia during the HBOT, oxygen toxicity was considered a possible diagnosis.