title: Fulminating septicemia secondary to oxygen-ozone therapy for lumbar disc herniation: case report.
abstract: METHODS
  A case report and clinical discussion.
  
  
  OBJECTIVE
  To describe a rare but fatal complication secondary to oxygen-ozone therapy for the treatment of herniated lumbar disc.
  
  
  BACKGROUND
  Previously reported complications secondary to oxygen-ozone therapy are rarely reported. Septic discitis and epidural abscesses have been reported after myelography, lumbar puncture, paravertebral injections, epidural anesthesia, acupuncture, and intradiscal therapy with chymopapain. We report the first case of a local infection with systemic fatal dissemination secondary to this treatment.
  
  
  METHODS
  A 57-year-old man previously treated with oxygen-ozone therapy presented low back and bilateral pain. The lumbar computed tomography revealed the presence of L4-L5 and L5-S1 herniated discs.
  
  
  RESULTS
  Three days after admission in the hospital, the patient developed a fulminant septicemia. An abdominal-pelvic and chest computed tomography and blood culture led to the diagnosis of pyogenic lumbar muscle involvement, accompanied with septic pulmonary embolism secondary to Escherichia coli infection.
  
  
  CONCLUSIONS
  This case report identifies a rare and fatal complication of oxygen-ozone therapy in the treatment of a herniated lumbar disc. Acute fatal septicemia should be considered among the major complications of the oxygen-ozone therapy in the treatment of a herniated lumbar disc.
authors.affiliation: Department of Neurosurgery, Ospedale San Giovanni Addolorata, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gazzeri
authors.forename: Marcelo
authors.initials: M
authors.lastname: Galarza
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Neroni
authors.forename: Stefano
authors.initials: S
authors.lastname: Esposito
authors.forename: Alex
authors.initials: A
authors.lastname: Alfieri
mesh_terms: D000208:Acute Disease; D017809:Fatal Outcome; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000628:therapy; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects*; D010126:Ozone / Q000009:adverse effects*; D011859:Radiography; D018805:Sepsis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000382:microbiology
chemical_list: D010126:Ozone