Nontuberculous mycobacterial hypersensitivity pneumonitis related to a home shower: treatment and secondary prevention. BMJ Case Rep 2011 Jul 28;2011
Date
01/01/2011Pubmed ID
22689847Pubmed Central ID
PMC3149474DOI
10.1136/bcr.06.2011.4360Scopus ID
2-s2.0-84860395999 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
A 57-year-old physician with increasing dyspnoea and hypoxaemia had a high-resolution CT scan of the chest, which disclosed diffuse pulmonary ground glass opacities, more pronounced in the upper lobes with minimal mediastinal lymphadenopathy. Transbronchial biopsy of the right middle and lower lobes was performed, demonstrating varying degrees of well circumscribed organising granulomatous pneumonitis thought to be most consistent with hypersensitivity to nontuberculous mycobacteria. Cultures of water obtained from the patient's home shower were positive for Mycobacterium avium complex. The patient began substituting baths for showers, experiencing some gradual improvement of his symptoms. Subsequently, he installed point-of-use 0.2 micron membrane filters on his shower, and resumed regular showering after installation with continued symptomatic improvement. CT scans at 3 and 18 months revealed improvement and resolution, respectively. Four years later, he continues to shower in filtered home shower water and remains clinically well.
Author List
Hankwitz PE, Cervia JS, Thomas CF, Fink JN, Marras T, Tomic RMESH terms used to index this publication - Major topics in bold
Alveolitis, Extrinsic AllergicBaths
Diagnosis, Differential
Filtration
Humans
Male
Middle Aged
Mycobacterium Infections, Nontuberculous
Risk Factors
Secondary Prevention
Tomography, X-Ray Computed
Water Microbiology
