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Updated: Jul 14, 2026

A Delayed Inoculation Model of Chronic Pseudomonas aeruginosa Wound Infection
Published on: February 20, 2020
[Whirlpool and pseudomonas infection--a local outbreak]
Kirsti Malterud1, Janecke Thesen
1Institutt for samfunnsmedisinske fag, Universitetet i Bergen, Kalfarveien 31, 5018 Bergen. kirsti.malterud@isf.uib.no
Hot tub use in Norway is linked to Pseudomonas aeruginosa infections, often mistaken for other conditions. Proper hot tub maintenance and monitoring are crucial to prevent these bathing-associated infections.
Area of Science:
- Dermatology
- Infectious Diseases
- Public Health
Background:
- Hot tubs and whirlpools are popular in Norway, with underrecognized health risks.
- Bathing-associated Pseudomonas aeruginosa infections can affect multiple organ systems.
- Pseudomonas folliculitis, a common manifestation, is typically self-limiting and requires no antibiotics.
Purpose of the Study:
- To describe a local outbreak of hot tub-associated Pseudomonas aeruginosa infections.
- To highlight the varied clinical presentations and potential misdiagnosis of these infections.
- To emphasize the importance of hot tub maintenance in preventing infections.
Main Methods:
- Case study of a local outbreak involving six individuals using the same hot whirlpool.
- Clinical observation and documentation of diverse disease manifestations.
- Bacteriological analysis of hot tub water to confirm the source of infection.
Main Results:
- The outbreak involved six people with varied symptoms, initially misdiagnosed as impetigo and mastitis/mammary tumor.
- Bacteriological specimens from the hot tub strongly suggested it as the source of Pseudomonas aeruginosa infection.
- The findings indicate that hot tub-associated Pseudomonas aeruginosa infections may be more common than previously thought.
Conclusions:
- Pseudomonas aeruginosa infections from hot tubs can present with diverse symptoms and be misdiagnosed.
- Inadequate hot tub maintenance is a likely cause of such infections.
- Implementing improved guidelines for hot tub owners and utilizing dip-slide cultures can help prevent bathing-associated Pseudomonas infections.
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