# Septic Arthritis of the Shoulder Following Ozone Therapy: A Case Report

## TL;DR

A 65-year-old man developed shoulder septic arthritis after ozone therapy, but the report does not prove ozone caused the infection.

## Contribution

This case report highlights a potential risk of ozone therapy and emphasizes the need for caution due to limited scientific evidence.

## Key findings

- The patient developed septic arthritis with Staphylococcus aureus after ozone therapy.
- Treatment with antibiotics led to clinical improvement over six months.
- The report does not establish a causal link between ozone therapy and septic arthritis.

## Abstract

Ozone therapy does not yet have a fully understood mechanism of action, and its use should be approached with caution. Septic arthritis, an acute joint infection, requires immediate intervention due to its severity and the risk of complications such as sepsis and permanent damage. This is a qualitative case report based on medical record analysis, along with a literature review on ozone therapy. A 65-year-old male patient with HIV, hypothyroidism, and systemic arterial hypertension presented with right shoulder pain, which worsened after undergoing ozone therapy. Upon admission to the emergency department, he exhibited signs of inflammation, restricted range of motion, a 60 cm³ subcutaneous fluid collection, and bone rarefaction on imaging. Surgical debridement was performed, with drainage of purulent secretion and collection of material for culture, which identified Staphylococcus aureus. Treatment with ciprofloxacin and sulfamethoxazole + trimethoprim was initiated for four weeks. The patient developed dry necrosis and necrosuppurative acute inflammation, with no signs of malignancy. After six weeks, laboratory improvement and pain resolution were noted. At six months, the patient reported good clinical progress and no symptoms. Although a temporal association was observed between ozone therapy and the onset of symptoms, this case report does not establish a causal relationship. Given the limited scientific evidence and regulatory concerns surrounding ozone therapy, its use should be approached with caution.