Decompression Sickness Differential Diagnoses

Updated: Mar 05, 2019
  • Author: Stephen A Pulley, DO, MS, FACOEP; Chief Editor: Joe Alcock, MD, MS  more...
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Diagnostic Considerations

Diagnostic considerations include the following:

  • General - Dehydration, electrolyte imbalance, viral syndrome, exhaustion
  • Mental status - Psychosis, hypoxia
  • Eyes - Ophthalmic migraine, CNS lesion
  • Ears - Tympanic membrane rupture, otitis media, external canal occlusion, round window rupture
  • Pulmonary - Bronchospasm
  • Cardiac - Pneumopericardium, supraventricular tachycardia
  • Gastrointestinal - Enteritis, motion sickness, viral food poisoning
  • Genitourinary - Urinary tract infection, prostatism, anticholinergic effect
  • Neurologic - Radiculopathy, neurapraxia, hypoxia, round window rupture, alternobaric vertigo
  • Musculoskeletal - Sprain, strain, fracture, fatigue, acute arthritis, herniated disk
  • Skin - Dermatitis, allergic reaction, envenomation, contusion, arterial occlusion
  • Toxicology - Carbon monoxide poisoning, marine life envenomation, substance abuse, medication adverse effects

As emphasized above, symptoms that occur following scuba diving may be due to decompression sickness (DCS). Many times, the only way to assist with this determination is a trial hyperbaric oxygen (HBO) recompression. However, some have symptoms temporally linked to diving that ultimately are determined to be nondiving-related issues. The take-home point is to consider DCS as a possibility but not to exclude others, especially if symptoms are atypical and the dive profile would not normally be expected to cause a problem.

Differential Diagnoses