Post piercing chondritis H61.0

Bacterial infection of the auricle caused by tranchondroidal piercing. The classical signs of infection such as redness, swelling, pain, overheating and abscess formation (see below perichondritis of the pinna).

Infections with Pseudomonas aeruginosa or Staphylococcus aureus.

Immediate removal of the piercing pin, antibiotic therapy after antibiogram.

In a previously healthy 15-year-old girl the upper part of her left ear was "pierced" in a boutique. The ear was previously cleaned with alcohol swabs and perforated with a straight, individually wrapped sterile needle. An individually wrapped metal pin was inserted into the hole. The practitioner wore gloves properly and had previously disinfected both hands.

Within 24 hours after the piercing, the perforated area reddened; it swelled and became painful. The ear was then treated with a solution of boiled water and salt. During the following days she suffered from progressive pain and swelling, followed by purulent secretion from this area. No fever. No regional lymphadenitis.

Therapy: removal of the pencil. The posterior upper helix was incised, the pus drained. Bandage with an iodine-based ointment. Internal administration of a cephalosporin for several days.

Culturally Pseudomonas aeruginosa was detected. This was sensitive to ciprofloxacin, ceftazidime and piperacillin-tazobactam. Antibiotics were switched to intravenous ciprofloxacin. Within 5 days the findings were largely healed. The antibiotic was discontinued.

1. Bellaud G et al (2017) Bacterial chondritis complications following ear piercing. Med Mal Infect 47:26-31.
2. Todd C et al (2011) Necrotizing Pseudomonas chondritis after piercing of the upper ear. CMAJ 183: 819-821.