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Kim, Cha, Shin, Yoon, Bae, Yoon, Lee, Kim, Park, and Jung: A Case of Hot Tub Lung
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 68(4): 236-239.

Published online: 30 April 2010

DOI: https://doi.org/10.4046/trd.2010.68.4.236

A Case of Hot Tub Lung

Min Kim, M.D.1, Seung-Ick Cha, M.D.1, Kyung-Min Shin, M.D.2, Ghil-Suk Yoon, M.D.3, Junghyun Bae, M.D.3, Won-Kyung Yoon, M.D.1, Shin-Yup Lee, M.D.1, Chang-Ho Kim, M.D.1, Jae-Yong Park, M.D.1, Tae-Hoon Jung, M.D.1

1Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

2Department of Radiology, Kyungpook National University School of Medicine, Daegu, Korea.

3Department of Pathology, Kyungpook National University School of Medicine, Daegu, Korea.

Address for correspondence: Seung-Ick Cha, M.D. Department of Internal Medicine, Kyungpook National University Hospital, 50, Samduk 2-ga, Jung-gu, Daegu 700-712, Korea. Phone: 82-53-420-6412, Fax: 82-53-426-2046, sicha@knu.ac.kr

Received 19 November 2009       Accepted 11 December 2009

Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

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.

Keywords: Hypersensitivity pneumonitis, Mycobacterium avium Complex, Hot Tub Lung

Figures and Tables

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.
trd-68-236-g001
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).
trd-68-236-g002
Figure 3
There is marked improvement of the previous lesion on chest radiograph two months later.
trd-68-236-g003

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