Upper-ear piercings at a shopping mall kiosk in Oregon in 2000 caused a rash of infections in preteens and teenagers. A study of the outbreak suggests that upper-ear cartilage is more susceptible to bacterial infections than lobes are.
Investigators closed the kiosk and took swabs of surfaces, equipment, and employees. Pseudomonas aeruginosa turned up in a bottle of disinfectant, in a sink used by employees and in two of the four employees tested.
When epidemiologist William E. Keene of the Oregon Department of Human Services in Portland and his colleagues contacted 118 people who had had a piercing during the previous month at the kiosk, they found that seven had P. aeruginosa infections of the upper ear and one had a Staphylococcus aureus infection of a lobe. Another 18 people had suspected ear infections that had shown redness, swelling, and discharge for more than 2 weeks. The results appear in the Feb. 25 Journal of the American Medical Association.
Four of the adolescents infected with P. aeruginosa required surgical drainage of their piercings, and some suffered ear disfigurements.
The cartilage of the upper ear has less circulation than the lobe, making cartilage infections slow to start but difficult to treat, says Myrna L. Armstrong, a nurse and medical researcher at Texas Tech University in Lubbock. The nose also consists mainly of cartilage and skin. While scientists have done less research on risks associated with nose piercings, anecdotal evidence suggests that these wounds are also susceptible to infection, particularly since the nose “is such a reservoir for organisms,” Armstrong says.
The Oregon kiosk used a spring-loaded gun for piercing. Such guns drive a tiny stud through the ear, damaging more tissue than a needle does and inviting infection, Armstrong says. Oregon banned the guns in 2001. Piercing remains poorly regulated in most states, Armstrong notes.