Complex bone infections continue to pose significant clinical challenges, often requiring prolonged antibiotic therapy, multiple surgical interventions, and extended hospitalizations. Despite appropriate conventional management, some patients experience recurrent infections, persistent inflammation, and severe functional impairment.

 

This clinical case illustrates how Hyperbaric Oxygen Therapy (HBOT), integrated as a complementary treatment, contributed to infection control, tissue recovery, and functional restoration in a patient with a severe and recurrent bone infection.

 

A Prolonged and Challenging Clinical Course

In October 2023, the patient was admitted with a severe infection affecting the right knee. Management required two surgical procedures followed by long-term, targeted antibiotic therapy.

 

Although she was discharged and initially stabilized, the patient experienced a relapse in November, leading to readmission. After antibiotics were discontinued according to medical indication, a more aggressive infection developed weeks later, characterized by high fever and disabling pain.

 

For several months, the patient was unable to bear weight on the affected limb and required continuous assistance for basic daily activities. Daily physiotherapy was essential to prevent severe muscle atrophy and further functional deterioration.

 

 

HBOT as a Complementary Therapeutic Strategy

 

In 2025, given the lack of sustained clinical improvement, the patient was referred for evaluation for Hyperbaric Oxygen Therapy (HBOT). The indication was based on HBOT’s known mechanisms of action in complex infections, including improved tissue oxygenation, enhanced leukocyte function, increased antibiotic penetration into bone, and modulation of inflammation—particularly relevant in cases of osteomyelitis and refractory infections.

 

The patient was evaluated at Dr. Arturo Umberto Illia Burn Hospital, where a Biobarica Revitalair hyperbaric chamber is in operation. Following a comprehensive clinical assessment, Dr. Mercedes Porta indicated an initial protocol of 20 HBOT sessions.

 

The response was favorable, with resolution of inflammatory signs and no new infectious episodes during the treatment period.

 

Consolidation of Clinical Improvement

 

Given the positive clinical evolution, a second cycle of 20 additional HBOT sessions was prescribed to consolidate the therapeutic response. Throughout and after this extended protocol, the patient remained free of infection recurrence or inflammatory flare-ups, confirming sustained clinical stability.

 

Functional and Systemic Outcomes

From the early stages of treatment, the patient reported significant changes. By the second HBOT session, she perceived improved stability and strength in the affected limb.

 

As treatment progressed, outcomes included:

 

• Significant pain reduction
  
  

• Progressive improvement in mobility
  
  

• Discontinuation of antibiotic therapy (July 2025)
  
  

• Independent ambulation within the home
  
  

• Improvement in systemic health parameters and laboratory markers
  
  

These results enabled the patient to return to daily activities and gradually resume part-time work.

 

 

Clinical Insights for Healthcare Professionals

 

This case reinforces the value of HBOT as an adjunctive, evidence-based therapy in the management of complex bone infections. While HBOT does not replace surgical or pharmacological treatment, it can significantly enhance outcomes when conventional approaches alone fail to achieve sustained resolution.

 

Early referral and appropriate patient selection remain key factors in maximizing therapeutic benefit.

 

Conclusion

 

For healthcare professionals managing challenging infectious cases, Hyperbaric Oxygen Therapy represents a powerful complementary tool that can improve tissue healing, reduce complications, and restore patient function and quality of life.

 

This case underscores the importance of a multidisciplinary approach and highlights how integrating HBOT at the right time can transform both clinical outcomes and patient trajectories.