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A mother of two on holiday with her family acquired a horrendous infection from a hotel hot tub that nearly cost her her leg.
Indianapolis resident Taylor Bryant was vacationing with her family in Tennessee earlier this year when she went to the hot tub to relax. Later that day, she felt nauseated and had cramping in her right leg, Bryant told WISH 8 News.
The pain was bad enough the next day for Bryant to visit an emergency medical clinic, where she received antibiotics. However, things only got worse from there.
Within days, a blistering rash on her lower leg appeared and began to expand, and pain was “worse than labor.”
Back home, Bryant took stronger antibiotics to no effect. She ended up in hospital for four days, being treated by an infectious-disease specialist. Her skin was turning black and purple, and the flesh beneath it was oozing and bubbling with pus. Doctors told her that if her condition continued to deteriorate, she might need her lower leg amputated.
“[Hearing that I might be] losing my leg, I instantly started crying,” Bryant told People. “It scared me to think that could happen so young, [especially] being a mom of two kids.”
A two-week course of intravenous antibiotics staved off the infection, and Bryant is back at work. However, four months after her ordeal started, Bryant’s leg is still healing; she has to apply cream twice daily and wear compression socks.
Bryant’s doctors suspected the infection stemmed from the hotel hot tub, with what’s known as “hot tub rash,” which then progressed more serious condition.
Hot tub rash is typically caused by bacteria called Pseudomonas aeruginosa. The organism is found in the environment in water and soil. According to the Centers for Disease Control and Prevention, hot tub rash is spread by skin contact with contaminated water and usually occurs within a few days of swimming in poorly maintained hot tubs or spas. It can also be spread by swimming in a contaminated pool or lake.
Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital, told Yahoo Canada that hot tub rash is usually a very mild condition, and that severe complications are extremely rare.
“It’s related to hot tubs that aren’t treated appropriately, not chlorinated appropriately, or that might not have the correct pH,” Bogoch said. “Bacteria is able to proliferate in that hot tub, and that bacteria can cause this rash.
“People can get a very mild skin infection related to the bacteria,” he says. “Typically, within eight hours to two days after being exposed to a hot tub, some people might get a bit of an itchy rash and sometimes the rash has little tiny drops of pus around hair follicles. The skin might be a little bit raised and can appear red. It’s mild, self-limiting, and goes away on its own, usually within a matter of a couple of days.”
Hot tub rash, which is also known as hot tub folliculitis, rarely requires antibiotics, Bogoch explained. Sometimes people put cold compresses or vinegar compresses on it for relief.
Although uncommon, hot tub rash could lead to a deeper, more serious infection. Bryant was diagnosed with cellulitis, a bacterial skin infection that, left untreated, can spread to lymph nodes and bloodstream and rapidly become life-threatening.
“Getting a secondary or superimposed skin or soft tissue infection from hot tub folliculitis may occur, but it would be rare,” Bogoch said. “Much more likely, people may have small cuts or abrasions on their skin, and if exposed to pseudomonas in the hot tub, this could allow for the bacteria enter this open area of skin and cause a skin or soft tissue infection.”
Another rare infection that can come from poorly maintained hot tubs is “hot tub lung”. It’s caused by a broad range of bacteria-like organisms called Nontuberculous mycobacteria that are distantly related to tuberculosis but are not contagious, Bogoch says. These organisms live in the environment, in air, water, and soil and can be inhaled. Most people aren’t affected, but some, particularly those with underlying lung disease or weakened immune system, will develop a progressive lung infection characterized by cough and shortness of breath.
Bryant went public with her story as a warning to others who like sitting in hot tubs.
“[This incident] changed my view on hot tubs,” Bryant told People. “I used to think they were nice and relaxing. Now I know how nasty they can be so fast. I will not be going back in one.”
“I want people to see the chance they take in hot tubs,” she said. “This can be just from a break of skin, for example, shaving [your] legs [and] then getting in [a] hot tub.”
Because the water in hot tubs is warmer than that of pools, chlorine or other disinfectants used to kill bacteria like Pseudomonas aeruginosa break down faster, which can increase the risk of hot tub rash or infection, according to the CDC.
It recommends asking the pool operator if disinfectant and pH levels are checked at least twice per day.
To reduce the risk of acquiring hot tub rash, people should remove and clean their bathing suit and shower with soap after getting out of the water.
Bogoch reminds that severe manifestations of hot tub rash are extremely unusual and that people don’t need to avoid swimming pools or hot tubs altogether out of fear of getting an infection.
“Of course, we need to have some caution with pools or hot tubs or places we swim in, but we have to live our lives and enjoy ourselves,” he said.
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