It May Be ‘Old Hat’, But Ear Piercing Still Can Be Dangerous
(HealthDay News) – The practicing of putting holes in one's ears so that ornaments can be attached to them is recorded further back than even the earliest civilizations of Egypt and China .
That's why it may seem remarkable that this ancient practice still carries with it the possibility of some serious infection.
It wasn't so long ago – seven years, in fact – that a bacterial outbreak threatened the health of seven teenagers who had gone to a kiosk at a shopping mall to get their ears pierced. The incident became a test case example of why ear piercing – like any other procedure involving penetrating the flesh – demands special attention.
In a short period of time in the fall of 2000, the seven teens were confirmed to have been infected with the bacterium Pseudomonas aeruginosa . Five were hospitalized, five required surgery and three ended up having reconstructive surgery to repair deformities.
"There were seven people we could confirm and probably dozens of others that were infected," says William Keene, the Oregon health official who responded to the initial reports and who later described at an annual meeting of the Infectious Diseases Society of America (IDSA).
All of the infected teens had had their upper ear cartilage pierced, which is much riskier than having the lobes pierced.
This type of infection appears to be more common following trauma, such as a stab wound, bites or wrestler's injuries, says Dr. Lindhe Guarisco, a pediatric otolaryngologist at the Ochsner Clinic Foundation in Baton Rouge , La. The infection is notoriously difficult to treat.
"Once the bacterium is in the cartilage, it's hard to get the antibiotic in there to kill it because there's such bad blood supply," Guarisco said. "I've had cases where I've had to stick catheters under the skin and shoot antibiotics directly under the skin and irrigate it continuously. When this occurs, it's a mess."
The only reason the health department came to know of the outbreak was because two infected teenagers happened to visit the same ear, nose and throat (ENT) specialist -- one of only two in the county -- within a few days of each other. When the doctor realized that both patients had had their ears pierced at the same establishment, he called the health department.
Clusters may have occurred in other parts of the country, but it's unlikely that health officials would ever know about them. But there are indications that infection is not uncommon.
Using sales records, health officials identified and interviewed 121 of 123 people who had had their ears pierced in the previous six weeks. Fifty-three people reported having their upper ear cartilage pierced and, of those, seven had confirmed P. aeruginosa infections. Their ages ranged from 10 to 19. In addition, more than one-third of the 53 people said that the piercing site had drained pus for weeks after the procedure, no doubt indicating additional infections that had healed on their own.
"They weren't life-threatening specifically, but they were pretty serious," Keene says. "Some had permanent disfigurement." These types of infections can cause the ear cartilage to erode so that the outer ear tissue sags and loses it normal shape.
Two things had gone wrong. First, both lobe and cartilage piercings were being done with a spring-loaded "gun," which shoots a stud through the ear tissue. These guns are generally not recommended for cartilage piercing and, in fact, are prohibited for that use in Oregon and several other states.
In addition, one of the workers (who was responsible for six of the confirmed infections) had sprayed the sterile gun with a commercial disinfectant. The bacterium was later found to be growing in both the disinfectant and in the sink. "It's a fine thing to wipe on a countertop," Keene says, but not on an already sterile gun.
"The people who were doing the procedures were not using proper techniques. They were basically just kids. They didn't understand the potential significance of what they were doing," Keene says. "The skin is an important barrier to infection. Most of the time it heals up and it's no big deal, but sometimes things can infect the wound that get ahead of your body's defenses. That's when you get a serious illness. That's what happened to these kids. It's a cautionary tale."
"So many different individuals perform piercing, and to do it right certainly requires some training and some knowledge of infection control procedures," says Dr. Edward Chapnick, director of the infectious disease division at Maimonides Medical Center in Brooklyn, N.Y. "Given the large number of individuals who do this, it's not surprising that there are some who are inadequately trained."
The safest thing is to avoid piercing all together, Keene says. If you do want to go that route, find a licensed store but even that may not be enough: The store in Oregon where the outbreak occurred was licensed.
Don't pierce sites other than the ear lobe, Chapnick advises. Piercing the tongue frequently invites infection. If you must pierce your ear cartilage, make sure it's done with a needle and not a gun.
"I would not encourage my daughters to get piercing through the cartilage. The risk is too high and the treatment [for an infection] is too difficult," Guarisco says. "The ears are going to malform in all of these children."
On the Web
The Association of Professional Piercers has information on the risks involved in body piercing.
SOURCES: William Keene, Ph.D., M.P.H., William Keene, senior epidemiologist, Oregon Public Health Division, Portland; Edward Chapnick, M.D., director, infectious disease division, Maimonides Medical Center, Brooklyn, NY; Lindhe Guarisco, M.D., pediatric otolaryngologist, Ochsner Clinic Foundation, Baton Rouge, La.; Oct. 25, 2002, presentation, Infectious Diseases Society of America annual meeting, Chicago
Author: Amanda Gardner, HealthDay Reporter
Copyright © 2007 ScoutNews, LLC . All rights reserved.
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