A case of hypersensitivity pneumonitis caused by inhalation of Mycobacterium avium from a home bath with a circulating water system

A 26-year-old man presented with complaints of exertional dyspnea and cough. The patient has already been given corticosteroids at a previous hospital. Chest CT revealed small centrilobular nodules with diffuse ground-glass opacities in both lungs. Lung biopsy specimens at thoracoscopy revealed non-...

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Bibliographic Details
Published inNihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society Vol. 43; no. 11; p. 689
Main Authors Kenmotsu, Hirotsugu, Honda, Atsuro, Baba, Tomohisa, Matsumoto, Yutaka, Shichi, Izumi, Eto, Takashi, Arai, Kazumori
Format Journal Article
LanguageJapanese
Published Japan 01.11.2005
Subjects
Adult
Alveolitis, Extrinsic Allergic - etiology
Alveolitis, Extrinsic Allergic - pathology
Baths - adverse effects
Humans
Immunocompromised Host
Male
Mycobacterium avium Complex - isolation & purification
Mycobacterium avium-intracellulare Infection - complications
Mycobacterium avium-intracellulare Infection - pathology
Water Microbiology
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Summary:A 26-year-old man presented with complaints of exertional dyspnea and cough. The patient has already been given corticosteroids at a previous hospital. Chest CT revealed small centrilobular nodules with diffuse ground-glass opacities in both lungs. Lung biopsy specimens at thoracoscopy revealed non-necrotizing granulomas, patchy foci of mononuclear cell infiltration and fibrous thickening of alveolar septa, and Masson's bodies in bronchioles. Sputum culture showed the growth of Mycobacterium avium complex (MAC). Culture of water from the bath tub of his home showed MAC. Administration of antituberculous drugs and corticosteroids, and avoidance of bathing at home resulted in the improvement of his symptoms and CT findings. We believe the case is hypersensitivity pneumonitis to MAC in an immunocompetent patient, simulating hot tub lung. Hypersensitivity pneumonitis caused by MAC is rare in Japan.
ISSN:1343-3490