Brain abscess linked to tongue piercing
By LEE BOWMAN/Scripps Howard News Service
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Scripps Howard News Service

A young Connecticut woman who recently got her tongue pierced wound up with an accessory she didn't bargain for -- a brain infection.

Doctors at Yale University's School of Medicine who treated her say they believe theirs is the first report of a brain abscess associated with tongue piercing.

``The bacteria that caused the abscess in this patient were those typically found in persons' mouths,'' said Dr. Richard Martinello, an infectious-disease specialist at Yale. ``We conclude the abscess potentially arose secondary to the tongue piercing associated infection.''

Martinello, assisted by Dr. Elizabeth Cooney, an associate professor of internal medicine, described the episode to colleagues at a recent meeting of the Infectious Diseases Society of America that was held in San Francisco.

The women, in her early 20s, reported that two to three days after her tongue was pierced, it became swollen and tender and had a foul-tasting discharge. ``After that, she gave up on tongue jewelry and took the barbell stud out, and the symptoms cleared up within a few days,'' Martinello said.

But about a month later, she began suffering from severe headaches, fever, nausea and vomiting, and also had difficulty maintaining her balance. She was referred to the Yale physicians when a CT scan performed done in an emergency room showed an abnormality in her brain at the cerebellum, the region that controls coordination and voluntary muscular activity.

``This was clearly a very dangerous infection,'' Martinello said.

Such abscesses are typically caused by infections that migrate from the sinuses or ears into the brain, the doctors said.

Yale surgeons drained the abscess, and the woman underwent six weeks of intravenous antibiotic treatment and made a full recovery.

Martinello said he wanted to publicize the case as a warning to those considering getting a body piercing and as an alert to those who do piercing, since they're most likely to see or hear about symptoms.

``Although the jewelry inserted through the tongue allows a ready tract for spontaneous drainage of infection, this procedure is likely at high risk for post-operative complication due to the presence of a foreign body in a warm, most, bacteria-laden environment,'' Martinello said.

The American Dental Association has concluded much the same thing, taking the official position that piercing the tongue, lip or cheek represents a public health hazard. The American Academy of Dermatology opposes all forms of body piercing, except the earlobes.

According to the dental organization, tongue piercing is especially likely to produce prolonged bleeding, since there are so many blood vessels in the organ. However, infections from pierced lips, cheeks and uvula (the small tongue-shaped piece of tissue that hangs from the top of the back of the mouth) are also common.

British doctors reported several years ago that they had to surgically remove the barbell-shaped jewelry from the tongue of a 25-year-old due to infection and swelling in the floor of her mouth that threatened to close off her airway.

And, at a medical meeting last fall, Dr. James Richardson of the Indiana School of Medicine, reported two other severe cases of infection arising from tongue piercing. One involved a 29-year-old woman who developed an infection in fluid around her heart; the other a 22-year-old woman who developed a breast abscess via a tongue bolt.

The National Institutes of Health has identified piercing as a possible vector for blood-borne hepatitis types B, C, D and G, and other infections.

On the Net:

http://www.ada.org

www.kidshealth.org

(Lee Bowman covers health and science for Scripps Howard News Service. E-mail BowmanL(at)shns.com)

AP-NY-12-13-01 1246EST







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