Cutaneous decompression sickness after an air dive with oxygen breathed during decompression in a commercial diver with a persistent foramen ovale

A 43-year-old commercial diver had cutaneous decompression sickness after a dive to 17 metres of seawater for 160 minutes breathing air with transfer under pressure and oxygen breathed during decompression in a dry chamber. He had worked as a commercial diver for 16 years without previous problems. A bubble contrast transthoracic echocardiogram showed a large atrial right-to-left shunt. His persistent foramen ovale (PFO) was closed using a transcatheter technique and he has returned to commercial diving. As far as we are aware, shunt-mediated decompression sickness has not been reported previously after a shallow air dive with oxygen breathed during decompression. The findings in this diver adds to the observation of occurrence of three episodes of cutaneous decompression sickness after dry hyperbaric exposure breathing air and decompression whilst breathing oxygen in two individuals with atrial right-to-left shunts.