Scuba diver develops deadly blood syndrome after deep cave dive
In a rare and alarming medical case, a scuba diver who explored the depths of an underwater cave found himself battling a life-threatening blood syndrome. The condition, known as systemic capillary leak syndrome (SCLS), occurs when fluid leaks out of the blood vessels. The incident was a peculiar complication of decompression sickness, commonly referred to as “the bends,” a condition where air bubbles form in the blood due to rapid pressure changes.
Typical symptoms of decompression sickness include joint pain, dizziness, and extreme fatigue. While potentially fatal, most individuals respond well to treatment, involving placement in a hyperbaric chamber with high pressure and oxygen flow. However, in this extraordinary case, which was published in the journal BMJ Case Reports on July 5, the diver developed SCLS but was fortunate to have received prompt treatment.
The patient, a man in his 40s, sought emergency medical attention the day after embarking on a deep cave dive lasting approximately 40 minutes at a depth of around 100 feet (30 meters) below sea level. The report noted that he presented “worsening shortness of breath” upon arrival at the hospital.
Dr. Ali Ataya, an associate professor of medicine at the University of Florida and an expert on capillary leak syndrome, played a crucial role in treating the diver and identifying several symptoms associated with SCLS. Ataya explained that SCLS is an extreme form of inflammation that causes blood vessels to leak the proteins responsible for retaining fluid. Consequently, fluid escapes from the cells, exacerbating the condition.
Regarding the root cause of this rare complication, Ataya suggested, “We think that the air bubbles that form from the ascent during decompression result in a pro-inflammatory cascade in the blood vessels, which causes them to become more permeable, resulting in the leakage of protein and fluid that leads to SCLS.”
Although SCLS often proves fatal, the swift diagnosis, resuscitation efforts, and treatment of the inflammatory cascade may account for the diver’s recovery within a week, allowing him to leave the hospital.
Dr. Jeffrey Cooper, a professor in the Department of Emergency Medicine at the University of Nebraska Medical Center, believes that this case serves as a reminder of the potential complications associated with deep diving. Cooper admitted that if a patient arrived at the emergency department with symptoms similar to the diver’s, the unusual presentation might initially lead them to consider alternative diagnoses like sepsis or an allergy.
Hence, Ataya emphasized the importance of physicians being aware of this potential complication. He stated, “When someone presents in shock with an unclear cause, we should always consider SCLS as part of the diagnosis.”
The incident should not discourage individuals from diving, as millions of people safely engage in the activity every year without experiencing this syndrome. However, it serves as a cautionary reminder to divers and medical professionals alike about the critical importance of understanding the potential risks associated with deep diving.