Tuberc Respir Dis.  2010 Apr;68(4):236-239.

A Case of Hot Tub Lung

• Kim M
• Cha SI
• Shin KM
• Yoon GS
• Bae J
• Yoon WK
• Lee SY
• Kim CH
• Park JY
• Jung TH

Abstract

Hot tub lung is a lung disorder associated with exposure to hot tub water contaminated with Mycobacterium avium complex (MAC). Although its pathogenesis remains unclear, it may be considered hypersensitivity pneumonitis (HP) rather than an infectious disease. We report a case which fulfilled the current diagnostic criteria of hot tub lung. A patient had worked as a cleaner in the public bath for approximately one year and presented with dyspnea for over one month. The computed tomographic finding of bilateral ground glass attenuation and pathologic finding of granulomatous inflammation were consistent with HP. MAC was isolated from bronchoalveolar lavage fluid and hot tub water. After corticosteroid treatment without antimycobacterial medication, the patient improved and there has been no recurrence. The patient has since discontinued working in the public bath.

Keyword

Hypersensitivity pneumonitis; Mycobacterium avium Complex; Hot Tub Lung

MeSH Terms

Alveolitis, Extrinsic Allergic
Baths
Bronchoalveolar Lavage Fluid
Communicable Diseases
Dyspnea
Glass
Humans
Inflammation
Lung
Mycobacterium avium Complex
Recurrence

Figure

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  Figure 1 (A) Chest radiograph shows multiple patchy infiltrates in both lower lung fields. (B) Chest CT scan demonstrates multiple ground glass attenuations (arrow heads) and patchy consolidations (arrow) in both lower lobes.

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  Figure 2 (A) Diffuse inflammatory infiltration along the interstitial tissues, especially around the bronchiole is noted (H&E stain, ×100). (B) There is a loosely formed noncaseating granuloma (arrow) with surrounding interstitial inflammation (H&E stain, ×200).

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  Figure 3 There is marked improvement of the previous lesion on chest radiograph two months later.

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