title: [Three case reports of breast abscess after nipple piercing: underestimated health problems of a fashion phenomenon].
abstract: OBJECTIVE
  Piercing is a growing fashion trend among young people. Nipple piercing has shown an increase over the last years. We report about three coincidental cases of breast abscess after nipple piercing within the last months in our clinics and discuss the related problems for health and society.
  
  
  METHODS
  Retrospective analysis of three case reports regarding course of illness and reasons as well as review of literature and internet.
  
  
  RESULTS
  Three patients average age 31.9 (28-35) years were hospitalized with breast abscess after nipple piercing (2 x left, 1 x right). The distance piercing to infection was on average 7.7 (5-12) months. In all patients the abscess was incised and the abscess cavity removed, two had an irrigation tubing for a three days, all received i. v. antibiotics postoperatively. Evidence for bacteria was found in case 1: PCR-confirmation of atypical mycobacteria and coagulase negative staphylococcus, case 2: coagulase negative staphylococcus and group B-streptococcus and case 3: green and microaerophilic staphylococcus. The length of hospital stay was on average 8.0 (6-9) days/case, the hospital costs were 3 624,54 e (3 000,26-4 310,58 e) euro;/case. In a follow-up period of 10,0 (5-15) months one relapse occurred which had to be re-operated.
  
  
  CONCLUSIONS
  Nipple piercing has grown in popularity within the last years and is in general not a stigma of a subculture or lower social classes any more. However, the risk for breast infection is on the one hand underestimated by the women and on the other hand played down by piercing studios. Breast infection after nipple piercing is rarely documented in scientific literature and data bases. Only seven case reports are scientifically published so far. Healing of the wound channel varies and can take up to 6-12 months. The risk for infection is approximately 10-20 %, often in a interval of months after the procedure. Insufficient understanding as well as inconsequent performance of hygienic preparation of the wound beneath other risk factors like nicotine abuse, wrongs size of jewelry, post breast enlargement with prosthesis etc. increase the risk of breast infection after nipple piercing. Due to obvious under documentation this is the largest series of breast infection after nipple piercing in the world.
authors.affiliation: Frauenklinik, Technische Universität München, Germany. volker.jacobs@hotmail.com
authors.forename: V R
authors.initials: VR
authors.lastname: Jacobs
authors.forename: K
authors.initials: K
authors.lastname: Golombeck
authors.forename: W
authors.initials: W
authors.lastname: Jonat
authors.forename: M
authors.initials: M
authors.lastname: Kiechle
mesh_terms: D000038:Abscess / Q000209:etiology*; D000328:Adult; D001424:Bacterial Infections / Q000209:etiology*; D001941:Breast Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D009558:Nipples / Q000293:injuries*; D012189:Retrospective Studies