Doctors issue dire warning about 'hot tub lung'

A Queensland teen has been rushed to hospital with what doctors have called “hot tub lung”.

The boy, 17, was taken to the emergency room 10 days after an ankle reconstruction with a cough, fevers and difficulty breathing, doctors wrote in Respirology Case Reports.

Doctors found he had a low amount of oxygen in his blood.

“No viral symptoms or other systemic symptoms including recent rashes, joint pain, or haematuria were reported,” doctors wrote.

“There was no prior medical or respiratory history. There was also no recent travel history or sick contacts; however, his younger brother (aged 14) had recent cough associated with dyspnoea and his mother reported having a persistent cough over the preceding three months.”

“Extensive crackles” were heard when doctors listened to breathing patterns in his chest. They gave him supplemental oxygen.

A CT scan of the chest of a boy, 17, with hot tub lung.
A 17-year-old who had been near his family's indoor pool developed hot tub lung. Source: Respirology Case Reports

A CT scan was also performed on his chest. Doctors asked the teen’s family about what he had been doing.

They told doctors he had been sitting in a media room near the indoor pool and the family had gone from a chlorine-based cleaner to a non-chlorine one.

“An occupational hygienist attended the family home and identified that mould was present in the house due to excess humidity, and that the family had a pet cockatiel which resided in their kitchen area,” doctors wrote.

“Additionally, microscopic analysis further identified another mould.

“Considering the environmental antigens present in the family home in conjunction with the patient's clinical course, a preliminary diagnosis of hypersensitivity pneumonitis (HP) was made.”

HP is a lung disease which causes inflammation of the lungs and makes breathing difficult.

Doctors noted nothing else the family told them, as far as the teen getting access to other water supplies, “precipitated this diagnosis”.

Water from the kitchen, bathrooms, and showers was tested at the Royal Brisbane and Women's Hospital.

From the indoor pool sample and a check of the teen’s lower respiratory system, Mycobacterium intracellulare was found. It’s a bacteria which can cause respiratory illness and can also lead to fever and weight loss.

Silhouette of man swimming as steam rises from pool.
Hot tub lung is caused by bacteria and germs in water vapour. Source: Getty Images (file pic)

Doctors diagnosed the teen with hot tub lung, which is a pulmonary disease caused by germs or bacteria in hot water steam.

None was found in other water sources in the house though but it was all cleaned anyway.

No other members of the family showed any serious signs of hot tub lung and were treated “conservatively”.

A follow up two years later showed the teen had fully recovered.

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