Re: Skin rash: Theory and suggestion

Hot Tub Cause of Man's Serious Lung Infection
Mon February 10, 2003 04:21 PM ET

NEW YORK (Reuters Health) - A severe lung infection caused by bacteria growing in a patient's hot tub highlights the importance of following guidelines for maintaining the tubs, according to Wisconsin researchers.

The 40-year-old man went to the emergency room after developing symptoms including fever, chills and a cough that produced blood. Although they initially feared the man had tuberculosis, doctors found that he had pneumonia caused by a bacterium known as Pseudomonas aeruginosa.

Doctors were initially stumped as to the cause of the infection, but when the man was interviewed further they learned that he owned a hot tub and had been using it daily for several weeks preceding his illness.

A laboratory test of the hot tub's filter later identified a strain of Pseudomonas aeruginosa identical to that present in the man's lungs.

The man was released from the hospital after 12 days and successfully treated with a six-week course of antibiotics, Christopher J. Crnich of the University of Wisconsin Hospital and Clinics in Madison and colleagues report in the February 1st issue of journal Clinical Infectious Diseases.

Although most healthy adults can fend off an infection with the bug, experts say that Pseudomonas aeruginosa infections can occur in people with immunodeficiency or chronic lung disease. The patient may have been more susceptible to the infection because he was an alcoholic and a smoker.

The bacterium is found naturally in soil, water, animals and plants. It can be released from water droplets, or from the steam in hot tubs, and then inhaled into the lungs.

The US Centers for Disease Control and Prevention suggests that hot tubs contain 1-3 milligrams of chlorine per liter of water and be kept at a pH of 7.2-7.8, according to the report.

Many users may not realize that chlorine quickly dissipates at water temperatures above 84 degrees Fahrenheit, and that bacteria can multiply if chlorine levels drop and pH rises for as little as 24 hours, according to the researchers.

"Therefore it is necessary to monitor these levels on a frequent basis, in order to make adjustments necessary to maintain the appropriate level of disinfection, and to change the water regularly, especially after heavy use," they conclude.