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Canadian Respiratory Journal
Volume 14 (2007), Issue 6, Pages 354-356
http://dx.doi.org/10.1155/2007/138270
Case Report

Hot Tub Lung Mimicking Classic Acute and Chronic Hypersensitivity Pneumonitis: Two Case Reports

Geetika Verma,1 Frances Jamieson,2 Pamela Chedore,3 David Hwang,4 Scott Boerner,4,5 William R Geddie,4 Kenneth R Chapman,1 and Theodore K Marras1

1Department of Medicine, Division of Respirology, University Health Network, University of Toronto, Canada
2Clinical and Environmental Microbiology, Public Health Laboratories Branch, Ontario Ministry of Health and Long-Term Care, Canada
3Tuberculosis and Mycobacteriology Laboratory, Public Health Laboratories Branch, Ontario Ministry of Health and Long-Term Care, Canada
4Department of Pathology, University Health Network, University of Toronto, Toronto, Ontario, Canada
5Department of Laboratory Medicine and Pathobiology, University Health Network, University of Toronto, Toronto, Ontario, Canada

Copyright © 2007 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pulmonary disease in otherwise healthy patients can occur by secondary exposure to nontuberculous mycobacteria from hot tubs. The pathology of hot tub lung may be related to an infection, a hypersensitivity reaction or both. Previous reports of hot tub lung have highlighted distinct pathological features that have distinguished this entity from classic hypersensitivity pneumonitis. Two cases of hot tub lung in Ontario, which presented at very different time points in their disease course, are reported; one patient presented more fulminantly with a clinical picture resembling subacute hypersensitivity pneumonitis, and the other presented with chronic disease. Both cases exhibited clinical, radiological and pathological findings closely mimicking classic subacute and chronic hypersensitivity pneumonitis.