title: Pseudomonas aeruginosa necrotizing chondritis complicating high helical ear piercing case report: clinical and public health perspectives.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, University of British Columbia, Vancouver.
authors.forename: Amonpreet
authors.initials: A
authors.lastname: Sandhu
authors.forename: Melissa
authors.initials: M
authors.lastname: Gross
authors.forename: John
authors.initials: J
authors.lastname: Wylie
authors.forename: Paul
authors.initials: P
authors.lastname: Van Caeseele
authors.forename: Pierre
authors.initials: P
authors.lastname: Plourde
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001505:Beauty Culture / Q000592:standards; D046288:Body Piercing / Q000009:adverse effects* / Q000592:standards; D002648:Child; D004425:Ear Cartilage / Q000293:injuries* / Q000473:pathology; D005260:Female; D006801:Humans; D009336:Necrosis; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000209:etiology*; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification*; D011634:Public Health; D014871:Water Microbiology; D014946:Wound Infection / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000900:Anti-Bacterial Agents