showed chronic and granulomatous inflammation, with focal active lung injury.
The BAL was negative for mycobacteria (specifically mycobacterium avium complex (MAC)). He was started on prednisone 60 mg and his symptoms are essentially resolved after 1 month of therapy. His followup CXR showed clearing of much of the prior acute interstitial infiltrates:
Final Diagnosis: Hypersensitivity pneumonitis ("Hot tub lung")
3 comments - CLICK HERE to read & add your own!:
Great case. Did he get rid of the hot tub?
Yes so it's difficult to tell with certainty whether his improvement is due to the steroids or to removal of antigen source. The data on steroid efficacy for HP suggests that steroids are not very effective for chronic HP (even before onset of fibrosis), but that it may be somewhat helpful for the acute phase.
Eur J Resp Dis 1983 64:283
Kokkarinen et al Am Rev Respir Dis 1992 145:3
why one has thought of MAC?
Post a Commenttest post a comment