Abstract • An epidemic of Pseudomonas aeruginosa folliculitis occurred in 117 persons. An indoor swimming pool at a dude ranch was the source of the infection. Recognition of the epidemic occurred through four patients who reported to our clinic with a characteristic syndrome of follicular pustular eruptions and associated symptoms. Inadequate disinfection of the water was causative. Many affected persons had prolonged contact with the organism because swimsuits were worn for several hours after exposure. Early diagnosis and epidemiological investigation are important in treating this disorder. (Arch Dermatol 1984;120:1304-1307) References 1. Pseudomonas dermatitis . City Health Information 1982;1: 2-3. 2. McCausland WJ, Cox PJ: Pseudomonas infection traced to motel whirlpool . J Environ Health 1975;37:455-459. 3. Skin rash associated with pool exposure—Minnesota . MMWR 1975;24:166-171. 4. Pool-associated rash illness—North Carolina . MMWR 1975; 24:349-350. 5. Washburn J, Jacobson JA, Marston E, et al: Pseudomonas aeruginosa rash associated with a whirlpool . JAMA 1976;235:2205-2207.Crossref 6. Sausker WF, Aeling JL, Fitzpatrick JE, et al: Pseudomonas folliculitis acquired from a health spa whirlpool . JAMA 1978;239:2362-2365.Crossref 7. Rash associated with use of whirlpool—Maine . MMWR 1979; 28:182-184. 8. Burkhart CG, Shapiro R: Pseudomonas folliculitis . Cutis 1980;25:642-643. 9. Outbreak of Pseudomonas aeruginosa serotype O:9 associated with a whirlpool . MMWR 1981;30:329-331. 10. Smith GC: Methods for preventing Pseudomonas folliculitis . Cutis 1981;29:378-381. 11. Hopkins RS, Abbott DO, Wallace LE: Follicular dermatitis outbreak caused by Pseudomonas aeruginosa associated with a motel's indoor swimming pool . Public Health Rep 1981;96:246-249. 12. Khabbaz RF, McKinley TW, Goodman R, et al: Pseudomonas aeruginosa serotype O:9: New cause of whirlpool-associated dermatitis . Am J Med 1983;74:73-78.Crossref 13. Silverman AR, Nieland ML: Hot tub dermatitis: A familial outbreak of Pseudomonas folliculitis . J Am Acad Dermatol 1983;8:153-156.Crossref 14. Grogan JB: Pseudomonas aeruginosa carriage in patients . J Trauma 1966;6:639-643.Crossref 15. Marples MJ: The Ecology of the Human Skin . Springfield, Ill, Charles C Thomas Publisher, 1965, p 690. 16. Cetin ET, Toreci K, Agbaba O, et al: Study of oral, nasal and skin flora in an investigation on hospital infection . Pathol Microbiol 1971;37:324-332. 17. Pillsbury DM, Rebell G: The bacterial flora of the skin . J Invest Dermatol 1952;18:173-186. 18. Aly R, Maibach HI, Shinefield H, et al: Survival of pathogenic microorganisms on human skin . J Invest Dermatol 1972; 58:205-210.Crossref 19. McBride ME, Duncan WC, Knox JM: Physiological and environmental control of gram-negative bacteria on skin . Br J Dermatol 1975;93:191-199.Crossref 20. Duncan WC, McBride ME, Knox JM: Experimental production of infections in humans . 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Savage TB, Stratton LP: Bacteriological evaluation of two test methods for chlorine in swimming pools . Appl Microbiol 1971; 22:809-811. 30. Suggested Health and Safety Guidelines for Public Spas and Hot Tubs , Dept of Health and Human Services publication 99-960. Atlanta, Centers for Disease Control, 1981. 31. Suggested Ordinances and Regulations Concerning Public Swimming Pools . Atlanta, Joint Committee on Swimming Pools in cooperation with Public Health Service, US Dept of Health and Human Services, 1964. 32. Standard Methods for the Examination of Water and Waste Waters , ed 15. New York, American Public Health Association, American Water Works Association, Water Pollution Control Federation, 1981. 33. Kush BJ, Hoadley AW: A preliminary survey of the association of Pseudomonas aeruginosa with commercial whirlpool bath waters . Am J Public Health 1980;70:279-281.Crossref 34. Young VM, Moody MR: Serotyping of Pseudomonas aeruginosa . J Infect Dis 1974;130:547-552. 35. Moody MR, Young VM, Kenton DM, et al: Pseudomonas aeruguinosa in a center for cancer research: I. Distribution of intraspecies types from human and environmental sources . J Infect Dis 1972;125:95-101.Crossref 36. Jacobson JA, Hoadley AW, Farmer JJ: Pseudomonas aeruginosa serogroup II and pool-associated skin rash . Am J Public Health 1976;66:1092-1093.Crossref 37. Chandrasekar PH, Rolston KVI, Kannangara DW, et al: Hot tub-associated dermatitis due to Pseudomonas aeruginosa: Case report and review of the literature . Arch Dermatol 1984;120:1337-1340.Crossref
Archives of Dermatology – American Medical Association
Published: Oct 1, 1984
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