title: Characterization of functional, radiologic and lung function recovery post-treatment of hot tub lung. A case report and review of the literature.
abstract: Hot tub lung is described as an acute pulmonary illness that is characterized by fever, dyspnea and interstitial nodular infiltrates. Although not entirely clear, the etiology may be a hypersensitivity pneumonitis, an infection secondary to Mycobacterium avium intracellulare (MAC), or possibly both. Herein we describe the most well-characterized physiologic, radiographic, and functional recovery from hot tub lung reported in the literature to date. Pulmonary function testing and CT scans of the chest were obtained after each therapeutic intervention, and the patient had the most dramatic improvement with simply avoiding the hot tub. Prednisone therapy offered minimal further improvement while anti-MAC therapy provided no further improvement. These results are suggestive of a hypersensitivity pneumonitis rather than an infectious etiology.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USA. marchent@tuhs.temple.edu
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Marchetti
authors.forename: Katharine
authors.initials: K
authors.lastname: Criner
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Criner
mesh_terms: D000542:Alveolitis, Extrinsic Allergic / Q000000981:diagnostic imaging / Q000382:microbiology / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008171:Lung Diseases / Q000145:classification* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection; D020127:Recovery of Function / Q000502:physiology*; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed; D014797:Vital Capacity / Q000502:physiology
references.citation: JAMA. 1978 Jun 2;239(22):2362-5
references.pmid: 642175
references.citation: N Engl J Med. 2000 Aug 31;343 (9):642-9
references.pmid: 10965012
references.citation: Chest. 1997 Mar;111(3):816-9
references.pmid: 9118727
references.citation: Am J Clin Pathol. 2001 May;115(5):755-62
references.pmid: 11345841
references.citation: Arch Intern Med. 2003 Oct 13;163(18):2250; author reply 2250-1
references.pmid: 14557226
references.citation: Chest. 1997 Jan;111(1):242-5
references.pmid: 8996025
references.citation: Emerg Infect Dis. 2001 Nov-Dec;7(6):1039-42
references.pmid: 11747738
references.citation: Emerg Infect Dis. 1999 Mar-Apr;5(2):270-3
references.pmid: 10221881
references.citation: Chest. 1997 Mar;111(3):813-6
references.pmid: 9118726
references.citation: Arch Intern Med. 2003 Apr 14;163(7):845-8
references.pmid: 12695276
references.citation: Mayo Clin Proc. 2002 Nov;77(11):1233-7
references.pmid: 12440560