Keene WE, Markum AC, Samadpour M: Outbreak of Pseudomonas aeruginosa infections caused by commercial piercing of upper ear cartilage. JAMA 2004;291(8):981-985.
Torpy JM, Lynm C, Glass RM: JAMA Patient Page: Body piercing. JAMA 2004;291(8):1024.
Ear cartilage, with its reduced blood flow, is more prone to serious infection than the earlobe. This is the first reported outbreak of upper ear cartilage infections following ear piercings. Over a 6-week period in Oregon, there were seven cases of confirmed Pseudomonas aeruginosa infections and eighteen suspected infections among 186 piercings in 118 individuals at one jewelry kiosk. Four persons were hospitalized, four underwent incision and drainage surgeries, and several were cosmetically deformed. All infections followed ear cartilage piercing with an open spring-loaded piercing gun. Patient isolates of P. aeruginosa were identical by molecular subtyping and also matched isolates recovered from a disinfectant bottle and sink in the kiosk. Upper ear cartilage piercing was significantly more likely to result in infection than lobe piercing (P <.001). Health care professionals can copy the patient page and use it to communicate to patients the risks of body piercing and questions to ask before undergoing piercing.