Pseudomonas aeruginosa Necrotizing Chondritis Complicating High Helical Ear Piercing Case Report

Abstract

Background: Auricular or high helical ear piercing is an increasingly widespread fashion trend that is associated with an increased risk of potentially serious post-piercing complications such as auricular perichondritis. Case report: An 11-year-old girl developed severe auricular perichondritis following piercing of the upper helical cartilage of her ear at a hairdressing salon. Four days post piercing, she returned to the same salon for a haircut during which the pierced site was manipulated. She presented to her family physician and was treated unsuccessfully with oral cephalexin. She was then referred to an infectious diseases consultant and received antipseudomonal intravenous antibiotics with subsequent resolution. She also required debridement and removal of necrotic cartilage. Public health investigation evaluated potential sources of infection including the piercing gun, disinfectant solutions, and hair cutting spray water bottles. Final culture results of the ear helical aspirate grew Pseudomonas aeruginosa. Pseudomonas aeruginosa was also cultured from one of the water bottles used to wet her hair during the haircut. Discussion: Although the pseudomonal strains from the water bottle were different than the infecting one, this contamination presents a potential source of wound infection. Damage to the helical cartilage caused by the piercing gun may also have contributed to this infection. Initial empiric antibiotic therapy for these kinds of infection must include anti-pseudomonal coverage. Auricular or high helical ear piercing using a piercing gun is not recommended. MeSH terms: Ear piercing; ear cartilages; pseudomonas infections La traduction du résumé se trouve à la fin de l'article.

Transcartilaginous ear piercing and infectious complications: A systematic review and critical analysis of outcomes

“…A total of 29 articles met inclusion criteria for this systematic review (Fig. ), and 66 patients were included in the pooled analysis (Table ).…”

Piercing associated perichondritis of the pinna: are we treating it correctly?

“…[3][4][5][6][8][9][10][11] Cephalexin was the most frequently administered (in-patient) first-line treatment worldwide, 3,5,6,9,10 with ciprofloxacin a common second-line agent. 1,3-17 The most common causative organism detected was P aeruginosa.…”

Body Piercing

“…Ahmed-Jushuf et al [41] Abscess Mycobacterium fortuitum Horii and Jackson [42] Auricular chondritis and perichondritis Lactobacillus spp. Razavi and Schilling [43] Pseudomonas aeruginosa Keene et al d [44] Lee and Gold [45] Sandhu et al [46] Fisher et al d [47] More et al [48] Turkeltaub and Habal [49] Stewart et al [50] Nonmenstrual toxic shock syndrome…”

“…Simple tears can be sutured under local anesthesia; however, larger defects may require reconstructive surgery. [45,46] Both chondritis and perichondritis have been reported. [41] Transcartilaginous piercings may be complicated by hematoma formation, which may result in cartilage ischemia or a severe deformity commonly referred to as 'cauliflower ear.'…”