updated 2/24/2004 4:37:35 PM ET 2004-02-24T21:37:35

Piercing the upper ear sometimes results in hard-to-treat infections that can lead to permanent disfigurement, according to a study of an Oregon outbreak.

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Seven youngsters ages 10 to 19 developed infections after getting their thin upper-ear cartilage pierced at a jewelry kiosk in Klamath Falls, Ore., in 2000. Doctors documented 18 other suspected cases linked to the store.

The source was found to be a common, hardy germ called pseudomonas aeruginosa that was found in a bottle of disinfectant that was supposed to be used only once but was reused repeatedly to sterilize earrings, said lead author William Keene, an Oregon Department of Human Services epidemiologist.

A pseudomonas infection can be treated with antibiotics, but upper-ear cartilage is harder to treat than earlobes; the cartilage has a poor blood supply, so there is no easy pathway for medication to reach the infection site. Treatment sometimes requires hospitalization, intravenous antibiotics and surgical removal of infected tissue.

Four patients left 'cosmetically deformed'
Four of the seven Oregon patients had surgery and several were left “cosmetically deformed,” the researchers said.

Their study and photographs of some of the deformities appear in Wednesday’s Journal of the American Medical Association.

Pseudomonas is a common cause of this type of infection, which Keene said probably occurs more often than public health officials realize. The germ lives in soil, water, plant and animal tissues, and can be found in plumbing fixtures such as shower heads and faucets.

Medical literature includes case reports of similar infections elsewhere in this country and in Britain, said Dr. Joseph Losee, chief of plastic surgery at Children’s Hospital of Pittsburgh. He said he has treated one case.

“It doesn’t happen that frequently, but boy, when it does happen, the consequences can be severe,” Losee said.

Keene said people who decide to have their upper ears pierced should be aware of the dangers and keep the piercing site clean.

Since the Oregon outbreak, the state has banned the type of piercing guns used on those infected and now requires ear-piercers to be at least 18 and have some basic first-aid training.

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