Two Cases of Hot Tub Lung in Bodyscrubbers Working in a Public Bath. |
Ji Young Bak, Kwang Sil Kim, I Nae Park, Ho Kee Yum, Seung Heon Lee, Hyun Kyung Lee, Young Min Lee, Hoon Jung, Jin Won Hur, Seong Soon Lee, Hyuk Pyo Lee, Soo Jeon Choi, Eun Ah Shin, Sang Bong Choi |
1Department of Internal Medicine, Paik Hospital, Inje University Collage of Medicine, Seoul, Korea. chsbong@paik.ac.kr 2Department of Pathology, Paik Hospital, Inje University Collage of Medicine, Seoul, Korea. |
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Abstract |
Hot tub lung has been described as a pulmonary illness associated with exposure to nontuberculous mycobacteria, mainly hot bathtub water contaminated with Mycobacterium avium complex (MAC) and hence the name. Although not entirely clear, its etiology has been thought to involve either an infection or a hypersensitivity pneumonitis secondary to MAC. Herein, we describe 2 female patients (60 and 53 years old) admitted to our hospital with hot tub lung, and both of whom worked in a public bath. Both women were initially admitted following several months of exertional dyspnea and cough. The patients had been working as body-scrubbers in a public bath for several years. Their chest CT scans showed bilateral diffuse ground-glass opacities with multifocal air-trappings and poorly defined centrilobular nodules in both lungs. Pathological findings from lung specimens revealed small non-necrotizing granuloma in the lung parenchyme with relatively normal-looking adjacent alveoli. Discontinuation of working in the public bath led to an improvement in symptoms and radiographic abnormalities, without antimycobacterial therapy. |
Key Words:
Hypersensitivity pneumonitis, Hot tub, Nontuberculous mycobacteria, Granulomatous lung disease |
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