The role of hyperbaric oxygen treatment in a case of pyomyositis

Pyomyositis is a serious bacterial infection of the skeletal muscles, usually treated with antibiotics and surgical drainage. The success of medical or surgical treatment is often delayed or less effective when tissue hypoxia is present. Hyperbaric oxygen therapy (HBOT) is currently being studied as a helpful additional treatment for various conditions, especially those involving complications of tissue hypoxia. In this case report, we describe a 29-year-old male who developed chronic pyomyositis and a right lower leg ulcer after failure of multiple surgeries, including fasciotomy, debridements, skin grafts and antibiotics to treat compartment syndrome and tuberculosis of the right knee. HBOT was administered for 80 sessions at 243 kPa (2.4 atmospheres absolute) for 90 minutes. The patient showed significant clinical improvement, as evidenced by the development of healthy granulation tissue, reduction in swelling and discharge, and better mobility. This case highlights the potential of HBOT as an additional treatment option for complex soft tissue infections such as pyomyositis caused by tuberculosis, especially in cases where traditional treatments have been ineffective.