| 'Hot Tub Lung' May Befall
Users of Dirty Hot Tubs
NEW YORK (Reuters
Health) - The cases of two women with
"hot tub lung" recently described by Mayo Clinic researchers reveal
the potential dangers of using a hot tub without cleaning it regularly.
The two women had respiratory illness
that was eventually traced to bacteria growing in their home hot
tubs. In both cases, the illness was likely not due to infection
with Mycobacterium avium complex (MAC) bacteria, but to hypersensitivity
to the infectious agent, according to Dr. Otis Rickman and colleagues
in Rochester, Minnesota.
The researchers describe the cases
of the women, aged 45 and 50, in the November issue of Mayo Clinic
Each woman had come to the Mayo
Clinic seeking a second opinion on their condition. Both were
being treated with corticosteroids based on their original diagnosis,
which was not helping their lung function. Their respiratory symptoms
and lung function progressively worsened, and computed tomography
scans of their lungs revealed signs of damage.
Both women reported frequently
using their home hot tubs, the report indicates.
Tests by the Mayo Clinic team revealed
the presence of MAC in each of the women's hot tubs. The women
were instructed to drain and clean the tubs and stop using them,
which led to speedy improvement of their respiratory symptoms
and lung function. The abnormalities seen on scans of their lungs
also disappeared. Neither woman was given drug therapy against
Hot tubs that are not routinely
cleaned provide an excellent breeding ground for the bacteria,
the authors note. Many users may not realize that at water temperatures
above 84 degrees Fahrenheit chlorine loses much of its disinfectant
ability, they point out. And bubbles and steam arising from heated
water carry MAC, making it easy to inhale.
Although most healthy adults can
fend off an infection with the bug, experts say that pulmonary
MAC infections usually occur in persons with immunodeficiency
or chronic lung disease. But both women seemed to be sickened
by hypersensitivity to the bacterium, rather than infection with
Although the results are inconclusive,
Rickman and his team believe that exposure to mycobacteria present
in the hot tub water led to inflammation of the women's lungs.
"Of note, all the cases of hot
tub lung reported in the literature have been associated with
a hot tub indoors at a personal residence," the authors write.
"We recommend that physicians maintain
a high index of suspicion for hot tub lung and include questions
about hot tub use in their routine review of symptoms in patients
with respiratory problems," Rickman said in a prepared statement.
SOURCE: Mayo Clinic Proceedings
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