PMID- 33761547 OWN - NLM STAT- MEDLINE DCOM- 20210326 LR - 20220401 IS - 1833-3516 (Print) IS - 2209-1491 (Electronic) IS - 1833-3516 (Linking) VI - 51 IP - 1 DP - 2021 Mar 31 TI - Hyperbaric oxygen treatment: Results in seven patients with severe bacterial postoperative central nervous system infections and refractory mucormycosis. PG - 86-93 LID - 10.28920/dhm51.1.86-93 [doi] AB - INTRODUCTION: Resistant bacterial infections following brain and spine surgery and spontaneous mucormycosis with central nervous system (CNS) involvement represent a serious treatment challenge and more efficient therapeutic approaches ought to be considered. Hyperbaric oxygen treatment (HBOT) has shown promise as a complementary therapy. This case series evaluated whether HBOT contributed to infection resolution in seven patients with refractory CNS infectious conditions. METHODS: Clinical results for seven patients referred for HBOT between 2010 to 2018 to treat refractory postoperative brain and spine infections or spontaneously developing mucormycosis were retrospectively analysed. The patients' clinical files and follow-up consultations were reviewed to assess evolution and outcome. RESULTS: Seven patients were referred with a median age of 56 years. The median follow-up was 20 months. Four patients had postoperative infections and three had rhino-orbital-cerebral mucormycosis (ROCM). HBOT was used as an adjunctive treatment to antimicrobial therapy in all patients. Prior to HBOT, all patients had undergone an average of four operations due to infection refractoriness and had completed an average of five months of antimicrobial therapy. After HBOT, infection resolution was obtained in six patients without additional operations, while one patient with ROCM stopped HBOT after the third session due to intolerance. Three patients stopped antimicrobial therapy while four were maintained on prophylactic treatment. CONCLUSIONS: Infection resolution was reached in the six patients that completed HBOT as prescribed. HBOT may serve as an effective complementary treatment in CNS refractory postoperative and spontaneous infections. CI - Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms. FAU - Valente Aguiar, Pedro AU - Valente Aguiar P AD - Neurosurgery Department, Centro Hospitalar Universitario Sao Joao, Oporto, Portugal. AD - Faculty of Medicine, Oporto University, Oporto, Portugal. AD - Corresponding author: Dr Pedro D Valente Aguiar, Department of Neurosurgery, Centro Hospitalar Universitario Sao Joao, Alameda Professor Hernani Monteiro, 4200-319, Porto, Portugal, pedrovalenteaguiar@protonmail.com. FAU - Carvalho, Bruno AU - Carvalho B AD - Neurosurgery Department, Centro Hospitalar Universitario Sao Joao, Oporto, Portugal. AD - Faculty of Medicine, Oporto University, Oporto, Portugal. FAU - Monteiro, Pedro AU - Monteiro P AD - Neurosurgery Department, Centro Hospitalar Universitario Sao Joao, Oporto, Portugal. AD - Faculty of Medicine, Oporto University, Oporto, Portugal. FAU - Linhares, Paulo AU - Linhares P AD - Neurosurgery Department, Centro Hospitalar Universitario Sao Joao, Oporto, Portugal. AD - Faculty of Medicine, Oporto University, Oporto, Portugal. AD - Neurosciences Centre, Hospital CUF, Oporto, Portugal. FAU - Camacho, Oscar AU - Camacho O AD - Hyperbaric Medical Unit, Unidade Local de Saude de Matosinhos, Portugal. FAU - Vaz, Rui AU - Vaz R AD - Neurosurgery Department, Centro Hospitalar Universitario Sao Joao, Oporto, Portugal. AD - Faculty of Medicine, Oporto University, Oporto, Portugal. AD - Neurosciences Centre, Hospital CUF, Oporto, Portugal. LA - eng PT - Case Reports PL - Australia TA - Diving Hyperb Med JT - Diving and hyperbaric medicine JID - 101282742 SB - IM MH - Humans MH - *Hyperbaric Oxygenation MH - Middle Aged MH - *Mucormycosis/therapy MH - Oxygen Inhalation Therapy MH - Retrospective Studies MH - Treatment Outcome PMC - PMC8313776 OTO - NOTNLM OT - Brain OT - Mucormycosis OT - Neurosurgery OT - Refractory infections OT - Spine COIS- Conflict of interest and funding: nil EDAT- 2021/03/25 06:00 MHDA- 2021/03/27 06:00 PMCR- 2022/03/31 CRDT- 2021/03/24 20:25 PHST- 2019/09/21 00:00 [received] PHST- 2020/11/08 00:00 [accepted] PHST- 2021/03/24 20:25 [entrez] PHST- 2021/03/25 06:00 [pubmed] PHST- 2021/03/27 06:00 [medline] PHST- 2022/03/31 00:00 [pmc-release] AID - 10.28920/dhm51.1.86-93 [doi] PST - ppublish SO - Diving Hyperb Med. 2021 Mar 31;51(1):86-93. doi: 10.28920/dhm51.1.86-93.