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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We read with great interest the case report of "hot tub lung" due to Mycobacterium avium complex in an immunocompetent host¹ and wish to share our experience of a husband and wife who nearly simultaneously presented with symptoms that we believe represent hypersensitivity pneumonitis from hot tub use.

A 57-year-old man and his 56-year-old wife presented with nonproductive cough, low-grade fever, and breathlessness of approximately 2 months' duration. The husband was treated with antibiotics without change in symptoms. A chest radiograph revealed right upper-lobe infiltrates. A computed tomographic scan of the thorax showed diffuse bilateral ground-glass densities consistent with alveolitis. His symptoms became more severe. Another course of antibiotics failed to alter the clinical course, and he was empirically started on prednisone therapy. Transbronchial lung biopsy revealed multiple, poorly formed, noncaseating granuloma and acute inflammatory cells surrounding the airways consistent with hypersensitivity pneumonitis. Special stains for acid fast bacilli were . . . [Full Text of this Article]

John M. Travaline, MD; Steven G. Kelsen, MD
Philadelphia, Pa

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