University of Wisconsin–Madison Medical College of Wisconsin

Hot Tub Lung: Case Report and Review of the Literature

Nathan D. Gundacker, MD; Jose Anel Gonzalez, MD; Yuri M. Sheinin, MD, PhD; Todd Hirschtritt, MD

WMJ. 2022;121(2):e31-e33

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Introduction: Nontuberculous mycobacteria-related hypersensitivity pneumonitits (NTM-HP), otherwise known as hot tub lung, is an uncommon disease produced by exposure to aerosolized hot tub water containing nontuberculous mycobacteria. Patients usually present with nonspecific, prolonged respiratory symptoms and require a thorough respiratory workup, including radiography and even pulmonary biopsies.

Case Presentation: We present the case of a 58-year-old patient with chronic respiratory symptoms and history of exposure to a hot tub.

Discussion: There is little data on why certain patients develop NTM-HP; however, it seems to be an immunologic response to the nontuberculous mycobacteria, not a primary infection. The treatment, as in this case, is typically just hot tub avoidance.

Conclusion: To our knowledge, this is the first case of NTM-HP reported from Wisconsin. NTM-HP can mimic nontuberculous mycobacterial disease and should be on the differential diagnosis for patients with unclear chronic respiratory problems.

Author Affiliations: Division of Infectious Diseases, Hospital Seguro Social, Panama City, Panama (Gonzalez); Department of Pathology, Medical College of Wisconsin (MCW), Milwaukee, Wisconsin (Sheinin); Department of Medicine, Division of Pulmonary Medicine, MCW, Milwaukee, Wisconsin (Hirschtritt); Department of Medicine, Division of Infectious Diseases, MCW, Milwaukee, Wisconsin (Gundacker); Zablocki VA Medical Center, Milwaukee, Wisconsin (Gundacker).
Corresponding Author: Nathan D. Gundacker, MD, Zablocki VA Medical Center, 5000 W National Ave, Milwaukee, WI 53295; email; ORCID ID 0000-0002-1614-5824.
Funding/Support: None declared.
Financial Disclosures: None declared.
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