Table 1.
Clinical features of hot tub lung.
| Clinical features | Case 1 | Case 2 | Case 3 | Case 4 | Review of literature (n = 55)a |
|---|---|---|---|---|---|
| Age (years) | 46 | 49 | 47 | 55 | 43.1 (range, 9–69) |
| Sex | F | F | F | F | 29/55 women (52.7%) |
| Indoor hot tub exposure | + | + | + | + | 38/55 (69.1%), shower in 1/55 (1.8%), outdoor tub/spa in 4/55 (9.1%), and unknown location of hot tub in 11/55 (20%) |
| Duration of hot tub exposure (in years) | 0.7 | 0.3 | 1.25 | 1.5 | Range, 1 month to 10 years |
| Duration of symptoms at presentation (in months) | 3 | 1 | 5 | 10 | Range, hours to 6 months (mean duration, 2 months) |
| Poor use practice | − | NR | − | NR | 15/16 cases (93.8%) |
| Smoking history | |||||
| Current smoker | + | − | − | − | 3/32 cases (9.4%) |
| Ex-smoker | − | − | − | + | 10/32 cases (31.3%) |
| Nonsmoker | − | + | + | − | 19/32 cases (59.4%) |
| Symptoms | |||||
| Dyspnea | + | + | + | + | 54/55 cases (98.2%) |
| Cough | + | + | + | + | 45/55 cases (81.8%) |
| Fever | + | − | − | + | 30/55 cases (54.5%) |
| Chest discomfort | + | + | − | − | 14/55 cases (25.5%) |
| Wheezing | − | − | + | − | 4/55 cases (7.3%) |
| Weight loss | + | − | − | − | 11/55 cases (20.0%) |
| Signs | |||||
| Bilateral crackles | − | − | − | − | 17/36 cases (47.2%) |
| Wheezing | − | − | − | + | 1/36 cases (2.8%) |
| Digital clubbing | − | − | − | − | 0/36 cases (0%) |
| Treatment modality | |||||
| Corticosteroids and abstinence | − | + | − | − | 19/55 cases (34.5%) |
| Antimycobacterial therapy and abstinence | − | − | − | − | 11/55 cases (20.0%) |
| Corticosteroids, antimycobacterial therapy, and abstinence | + | − | − | + | 13/55 cases (23.6%) |
| Abstinence alone | − | − | + | − | 12/55 cases (21.8%) |
| Response to treatment | |||||
| Resolution of disease | + | + | + | + | 38/53 cases (71.7%) |
| Partial resolution of disease | − | − | − | − | 15/53 cases (28.3%) |
| No change or worsening | − | − | − | − | 0/53 cases |
| Alternative diagnosis entertained | |||||
| Infection | − | + | + | − | 4/26 cases (15.4%) |
| Sarcoidosis | + | − | − | + | 6/26 cases (23.1%) |
Abbreviations: −, no; +, yes; F, female; NR, not reported. Not all data were reported for each patient.
a
Adapted from multiple references as noted in the text.