(1) Respiratory dysfunction linked directly to hot tub use, due either to infection by or hypersensitivity to Mycobacterium avium complex (MAC) growing in hot tub water (2) Hypersensitivity pneumonitis linked to recreational use of a hot tub caused by Cladosporium spp, an aeroallergenic fungi of the class Deuteromycetes
Huitt noted that in a recent series of 27 patients with hot tub lung reported by her colleagues in the occupational medicine group at National Jewish, the disease resolved or improved with treatment in all cases.
Patients with hot tub lung typically are previously healthy and younger than those with other NTM-associated pulmonary disease.
DATA SYNTHESIS: We summarized the clinical presentation and investigations of four presumptive cases and reviewed previously reported cases of hot tub lung.
Recently, hypersensitivity pneumonitis (HP)-like granulomatous lung disease with NTM from exposure to hot water aerosols from hot tubs/spa pools, showers, and swimming pools has been described in immunocompetent individuals (also called "hot tub lung," because the greatest number of cases are associated with hot tubs) (Aksamit 2003; Cappelluti et al.
Differentiation from hot tub lung (a hypersensitivity pneumonitis-like disease; see below) is more difficult and may be impossible on histologic grounds.
Hot tub lung is a recently described entity characterized by a hypersensitivity pneumonitis-like response to nontuberculous mycobacteria (specifically, Mycobacterium avium complex, abbreviated as MAC) inhaled in aerosol form from hot tubs.