Septic Arthritis of the Shoulder Following Ozone Therapy: A Case Report
Cortez F, Roncolato E, Machado M, Cubas V. Cureus, 2026.
- Study type
- Case report
- People studied
- 1 person
- Population
- 65-year-old man with HIV (low viral load), hypothyroidism, and hypertension, given a single ozone therapy session by a physical therapist for right shoulder pain
- Published
- 2026, Cureus
- Identifiers
- PMID 41728388, DOI 10.7759/cureus.101935
What the authors reported
After a single ozone therapy session with a physical therapist for two years of right shoulder pain, the patient worsened; 15 days later he had inflammatory signs, a 60 cm³ subcutaneous collection, and bone rarefaction of the clavicle and acromion. Debridement drained pus, and culture grew Staphylococcus aureus. After four weeks of oral antibiotics he had no pain at six weeks or six months.
What limits this result
Single case report; the authors state that it does not establish a causal relationship and that patient comorbidities, including HIV, and procedural factors cannot be excluded. The ozone route, injection site, and dose are not reported.
Harms reported after ozone therapy, and studies of how ozone exposure affects health. One study rarely settles a medical question; our guides weigh each paper against the rest of the evidence.
How the study was done
- Design
- Case report based on medical record analysis, with a literature review on ozone therapy
- Setting
- Mackenzie Evangelical University Hospital of Paraná, Curitiba, Brazil
The study was conducted at the Mackenzie Evangelical University Hospital of Paraná, Curitiba, Brazil, and the patient provided informed consent.
- Read from
- Read from the full text of the paper. Read on October 2, 2026.
Study arms
| Group | Participants | What they received |
|---|---|---|
| Single patient | Not reported | A single session of ozone therapy with a physical therapist, 15 days before admission, for right shoulder pain; followed by significant clinical worsening |
Source: Full text on PubMed Central
Procedure as reported
- Sessions
- A single session
a single session of ozone therapy with a physical therapist 15 days prior
In the paper's own units, not converted.
Source: Full text on PubMed Central
What it measured
- Examination on admission
- Inflammatory signs in the right shoulder, regional hyperemia, and impaired range of motion
- Ultrasound on admission
- Poorly defined 60 cm³ subcutaneous fluid collection
An ultrasound performed the same day revealed a poorly defined 60 cm³ subcutaneous fluid collection.
- Shoulder X-ray on admission
- Marked bone rarefaction of the acromial end of the clavicle and the acromion, degenerative acromioclavicular changes, increased soft tissue volume
- Surgical debridement
- Large amount of purulent discharge, an infected bursa, necrotic tissue, and distal clavicular bone involvement
- Culture and histopathology
- Staphylococcus aureus; fibromuscular tissue with intense necrosuppurative acute inflammation, without malignancy
- Discharge and antibiotics
- Discharged three days after surgery on oral ciprofloxacin and sulfamethoxazole + trimethoprim for four weeks
Three days later, the patient reported preserved muscle strength and sensitivity, with mild pain, and was discharged for outpatient oral antibiotic therapy (ciprofloxacin and sulfamethoxazole + trimethoprim) for four weeks.
- Seven days after surgery
- Dry necrosis of the anterior shoulder, purulent discharge at the wound edges, and serous drainage on pressure
Seven days post surgery, the patient returned for follow-up with dry necrosis in the anterior right shoulder area, purulent discharge at the wound edges, well-approximated sutures, and serous drainage upon pressure
- Six-week follow-up
- Inflammatory markers improving, degenerative joint changes on radiography, no pain
At the six-week follow-up (October 23, 2024), lab results indicated improving inflammatory markers (Table 1 ), and radiography showed degenerative joint changes (Figures 4 , 5 ), though the patient reported no pain.
Source: Full text on PubMed Central
Safety as reported
Septic arthritis of the shoulder after ozone therapy; the authors state that the association is temporal and that the report does not establish a causal relationship
Source: Abstract on PubMed
Follow-up
Six months: well, with no pain and good clinical recovery
Source: Full text on PubMed Central
Funding and conflicts
No financial support received from any organization for the submitted work
Source: Full text on PubMed Central
Where we cite this study
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