title: [Whirlpool and pseudomonas infection--a local outbreak].
abstract: BACKGROUND
  Hot tubs and whirlpools are popular in Norway, but related health risks are not well-known. Manifestations of bathing-associated Pseudomonas aeruginosa-infections can be seen in many organ systems. The most common of these, Pseudomonas folliculitis, is a self-limiting disease in otherwise healthy people, and does not require antibiotic treatment.
  
  
  METHODS
  We describe a local outbreak involving 6 people who had used the same hot whirlpool. The disease manifestations were different, and were initially confused with impetigo and mastitis/mammary tumour.
  
  
  CONCLUSIONS
  Signs and symptoms are described, documented with photos and discussed in relation to knowledge about Pseudomonas infection and its manifestations. After suspecting the hot tub as a source of infection, diagnosis was made highly probable by bacteriological specimens from the tub. Hot tub-associated infections with Pseudomonas aeruginosa are probably more common than previously anticipated, and can easily be confused with conditions of different aetiology. They indicate unsatisfactory routines in tub maintenance. Improved guidelines for hot-tub-owners and the use of dip-slide cultures to secure routines are likely to prevent bathing-associated Pseudomonas infections.
authors.affiliation: Institutt for samfunnsmedisinske fag, Universitetet i Bergen, Kalfarveien 31, 5018 Bergen. kirsti.malterud@isf.uib.no
authors.forename: Kirsti
authors.initials: K
authors.lastname: Malterud
authors.forename: Janecke
authors.initials: J
authors.lastname: Thesen
mesh_terms: D000328:Adult; D001494:Baths; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006920:Hygiene; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012307:Risk Factors; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D014871:Water Microbiology