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Canadian Journal of Public Health

, Volume 98, Issue 1, pp 74–77 | Cite as

Pseudomonas aeruginosa Necrotizing Chondritis Complicating High Helical Ear Piercing Case Report

Clinical and Public Health Perspectives
  • Amonpreet Sandhu
  • Melissa Gross
  • John Wylie
  • Paul Van Caeseele
  • Pierre PlourdeEmail author
Article

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 

Résumé

Contexte

Le perçage du haut de l’oreille, une mode qui s’étend de plus en plus, est associé à un risque accru de complications post-perçage potentiellement graves, comme la périchondrite de l’oreille.

Exposé de cas

Une fillette de 11 ans a contracté une périchondrite grave de l’oreille après le perçage du cartilage du tiers supérieur du pavillon de son oreille dans un salon de coiffure. Quatre jours après l’intervention, elle est retournée au même salon pour une coupe de cheveux durant laquelle le site percé a été manipulé. Elle s’est présentée chez son médecin de famille, qui lui a administré sans succès un traitement oral à la céphalexine. Elle a ensuite été dirigée vers un consultant en maladies infectieuses, où elle a reçu des antibiotiques antipseudomonaux par voie intraveineuse qui ont guéri l’infection. Il a aussi fallu exciser et retirer le cartilage nécrosé. Les enquêteurs de la santé publique ont analysé les sources d’infection possibles, dont le pistolet de perçage, les solutions désinfectantes et les flacons du salon de coiffure servant à pulvériser l’eau. Les derniers résultats de culture de l’aspirat du pavillon de l’oreille ont développé des bactéries Pseudomonas aeruginosa. Ces bactéries se sont également développées dans les cultures provenant d’un des flacons utilisés pour mouiller les cheveux de la fillette pendant sa coupe de cheveux.

Discussion

Bien que les souches pseudomonales du flacon aient été différentes de celle ayant infecté la fillette, cette forme de contamination pourrait avoir été une source d’infection de la plaie. La lésion du cartilage auriculaire causée par le pistolet de perçage pourrait aussi avoir joué un rôle dans l’infection. L’antibiothérapie empirique que l’on utilise initialement pour traiter ce genre d’infection doit inclure un agent antipseudomonal. Le perçage du haut de l’oreille à l’aide d’un pistolet n’est pas recommandé.

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Copyright information

© The Canadian Public Health Association 2007

Authors and Affiliations

  • Amonpreet Sandhu
    • 1
  • Melissa Gross
    • 2
  • John Wylie
    • 3
  • Paul Van Caeseele
    • 2
    • 3
  • Pierre Plourde
    • 4
    Email author
  1. 1.Department of PediatricsUniversity of British ColumbiaVancouverCanada
  2. 2.Department of Pediatrics and Child HealthUniversity of ManitobaWinnipegCanada
  3. 3.Cadham Provincial LaboratoryWinnipegCanada
  4. 4.Population and Public Health ProgramWinnipeg Regional Health AuthorityWinnipegCanada

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