Infections (bacterial and
fungal)
Hyperbaric Oxygen Therapy (HBO) is used as adjunctive treatment to the
following infections:
Bacterial
- Crepitant
anaerobic cellulitis – necrotic soft tissue infection caused by both
aerobic (E. coli, Klebsiella, Enterobacter and Pseudomonas) and
anaerobic Peptostreptococcus and Bacteroides).
- Necrotizing
fasciitis – skin necrosis with infection of the deep fascia and
thrombosis of the vessels following surgery or other trauma
- Progresive
bacterial gangrene – chronic ulcer formation on the abdominal or
thoracic wall developed after surgery at the site of drainage, around
colostomy or ileostomy.
- Nonclostridial myonecrosis – soft
tissue infection with involvement of skin, muscle, subcutaneous tissue
and fascia, particularly in conditions such as; Diabetes mellitus,
perirectal abscess, obesity and cardio-renal disease.
- Fournier’s
gangrene – perineal gangrene especially in people with diabetes and
elderly as well as in trauma, local or systemic infections
- Gas gangrene – see Gas gangerene
- Pyoderma
gangenosum – necrotic ulceration of the limbs and trunk mostly seen in
ulcerative colitis, cholecystis, pyelonephritis (kidney infection) and
other infection-prone (low immunity system) conditions.
- Purpura
fulminans – acute and severe disorder of infancy with characteristics
hemorrhagic lesions of the limbs that could rapidly turn into necrosis.
Children are usually affected after Varicella, Scarlet fever,
streptococcal tonsillitis or some thrombocytopenic disease.
- Actinomycosis
– anaerobic infection of abdominal, pelvic, cervicofacial and thoracic
area due to low oxygen level that predisposes fast growth of bacteria.
Fungal
- Candida albincans
- Rhinocerebral
Mucormycosis – fungal infection of lungs, brain, intestine and bone
(maxilla, orbit and temporal bone) that occurs most commonly in
immune–suppressed people with burns, diabetes and those who are on
long-term corticosteroid therapy.
Clinical application of Hyperbaric Oxygen (HBO) as an adjunct to
antibiotic therapy and surgery
- HBO increases the tissue oxygen tension and provides
adequate oxygen supply to infected area
- HBO acts as an antibiotic (bactericidal and
bacteriostatic), therefore impairs metabolism of microorganisms
- HBO produces free oxygen radicals that are toxic to bacteria
- HBO enhances antibiotics and antifungal activity
- HBO assists leukocyte in killing mechanism (phagocytosis)
- HBO arrests infection and prevent sepsis development
- HBO speeds up wound healing
- In bone infections HBO helps in removal of necrotic bone
(osteoclastic function) and speeds up new bone formation (osteogenesis)
- HBO increases immune system defense capacity
