The disease is acute onset, presenting initially as severe pain in the affected area. Swelling of the involved area occurs early, and the overlying skin appears pale and tense followed by a bronze discoloration with fluid or blood filled blebs. The wound drains a watery, brown or bloody fluid which often has a sweetish smell. The patient is oriented, alert, but apprehensive. Delirium and coma are late and grave signs.
Fever is low grade and a rapid heart rate is present.
Treatment of this infection is a medical emergency. HBO produces a rapid disappearance of toxicity, stops the spread of the infection, and decreases the magnitude of the necessary surgical debridement. A chronic bone infection is very difficult to cure even with prolonged parenteral antibiotics and surgery to remove dead infected bone. Following initial medical evaluation, the patients are given 40 daily adjunctive HBO treatments. In addition to HBO, each patient is followed by the Divisions of Infectious Diseases and Orthopedic Surgery.