HistoryThis section has been translated automatically.
Mc Causland 1976
DefinitionThis section has been translated automatically.
Harmless infectious disease of the skin originally described in the USA, now occurring worldwide, occurring 8-48 hours after bathing in warm water contaminated with Pseudomonas spp. The disease occurs more frequently in the cold season (note: this is probably related to the increased use of warm communal bathrooms in winter).
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PathogenThis section has been translated automatically.
EtiopathogenesisThis section has been translated automatically.
Clinical featuresThis section has been translated automatically.
Strongly pruritic, follicularly accentuated, maculopapular, also pustular dermatitis with accentuation of the runpf and here especially of the lateral throax sections.
Less common is the simultaneous occurrence of painful papules and nodules on the palms and/or soles of the feet (whirl-pool dermatitis with "hot hands/feet - see also hot-foot syndrome).
Differential diagnosisThis section has been translated automatically.
Scabies: evidence of the characteristic ganglionic structures
Prurigo simplex subacuta: Eminently chronic, polyetiologic, endogenously triggered, often accompanied by intolerable itching 0or also painful itching, papular, inflammatory disease of the skin with typical, disseminated, symmetrical distribution pattern.
Varicella and other viral exanthema: acute onset with involvement of oral mucosa and capillitium. Mostly endemic distribution.
Non-tuberculous mycobacteriosis (e.g., M. intermedium): M. intermedium can be transmitted by contaminated water from hot tubs and causes granulomatous dermatitis (see Fig.).
General therapyThis section has been translated automatically.
External therapyThis section has been translated automatically.
Internal therapyThis section has been translated automatically.
If spontaneous healing does not occur, or if external measures are not sufficient, it is recommended to use ciprofloxacin (e.g. Ciprobay) 250 mg p.o. 2 times/day.
In severe cases, ceftazidime (e.g., Fortum) 2-3 times/day 1-2 g i.v.
Alternatively (e.g., in penicillin allergy): Tobramycin (e.g., Gernebcin) adults 3-5 mg/kg bw/day i.m. or i.v. divided into 3 EDs (30-60 min short infusions). Children: 5-7 mg/kg bw/day i.m. or i.v. divided into 3-4 ED.
Progression/forecastThis section has been translated automatically.
Spontaneous healing after 10-14 days. Septic complications are rare.
Note(s)This section has been translated automatically.
Through whirlpool baths other infections can be transmitted, even if rarely, e.g. atypical mycobacteria.
Case report(s)This section has been translated automatically.
A 35-year-old man complaining of great stress noticed a sudden itchy rash on the trunk. At the same time, slight malaise, pulling of the chest muscles ("like sore muscles"), painful lump in the right axilla.
Findings: On the shoulders, upper arms and front of the trunk, highly red, maculopapular dermatitis with follicularly bound red papules and few pustules. Right-sided dolled axillary lymphadenopathy.
Smear pustule: abundant Pseudomonas aeruginosa, also Staphylococcus aureus.
On inquiry: New Year's vacation together with 2 friends. Use of the in-house hot tub. Skin symptoms 2 days later.
Therapy: Ciprofloxacin 2 times/day 250 mg p.o. for 5 days and external application of a 0.2% gentamicin lotio for 5 days.
LiteratureThis section has been translated automatically.
- Berrouane YF (2000) Outbreak of severe Pseudomonas aeruginosa infections caused by a contaminated drain in a whirlpool bathtub. Clin Infect Dis 31: 1331-1337
- Edson RS et al (2006) Mycobacterium intermedium granulomatous dermatitis from hot tub exposure. Emerg Infect Dis 12: 821-3
- Schirren CG et al (1992) Whirlpool dermatitis: A new epidemic recreational dermatosis. Dt Ärztebl 89: 1756-1758
Silverman AR et al (1983) Hot tub dermatitis: a familial outbreak of Pseudomonas folliculitis. J Am Acad Dermatol 8:153-156
Yu Y et al (2007) Hot tub folliculitis or hot hand-foot syndrome caused by Pseudomonas aeruginosa. J Am Acad Dermatol 57:596-600
Incoming links (6)Folliculitis gramnegative; Folliculitis superficial; Mycobacterium intermedium; Neutrophilic eccrine hidradenitis; Pseudomonas infections; Whirlpool dermatitis;
Outgoing links (15)Antibiotics; Antiseptic; Atypical mycobacterioses; Ceftazidim; Ciprofloxacin; Conjunctivitis; Gentamicin; Gentamicin cream 0,1%; Hot-foot syndrome; Mastitis; ... Show all
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