Pseudomona Chondritis and Ear Piercing Pseudomona and Piercing

Abstract

We describe a case of perichondritis by Pseudomona aeruginosa after piercing of the right posterior third of the ear pinna cartilage (high ear piercing) in an otherwise healthy Caucasian adolescent female of 16 years old at a local shop. Based on the tissue sample culture, she was successfully treated with ceftriaxone after a non-respondent first treatment, minimizing the destruction of the ear.A review of the history of body piercing, complications, risk factors, and treatments is presented with this increasing practice around Western cultures. Bodypiercing-associated cutaneous bacterial infections have been reported with increasing frequency, being Staphylococcus aureus the cause in the majority of the cases. Unlike Staphylococcus, Pseudomona is usually more aggressive and non-respondant to cephalexin or Trimethoprim/Sulfamethoxazole (TMP/SMX). Complications in the piercing site, especially in regions with low blood supply, such as the ear cartilage as in this case, may occur . Hence, awareness of the precise diagnosis and aggresive adequate treatment must be installed without delay in order to minimize destruction of tissue. KeywordsChondritis; Body Piercing; Pseudomona Chondritis; Case ReportA previously healthy 16-year-old girl had the upper portion of her right ear pierced at a local shop of tattooing and body piercing. The type of body piercing earring she had was an industrial bar made of titanium and placed it in a diagonal way using a spring loaded piercing gun (Figure 1). Three days after the amateur body piercing, she developed erythema and increasing pain associated with edema in the perforated area. Since day 1, she had been cleaning the pierced area with sterile gauze embedded in saline solution. As the inflammation kept increasing, she was seen at another hospital and unsuccessfully treated with oral cephalexin 2 grs per day for four consecutive days. Two days after, the patient finally underwent incision and drainage surgery of the abscess, which was repeated once again during the following week. (Figure 2) This practice included drainage of pus and blood. Pus sample was inmediately sent in a sterile specimen container to the microbiology laboratory for typification and culture. In 24 hs we received the diagnosis of Pseudomona aeruginosa.