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While in Thailand, a 21-year-old woman had her left upper ear cartilage pierced by a professional piercer. It was done in a sanitary environment in Koh Pha Ngan, Thailand, near the beach of Hat Rin. The ear was swabbed with an unknown solution and local anes-thetic was injected with a syringe before piercing. The patient presumed the curved stainless steel needle used to pierce the ear to be sterile because it was removed from packaging. A titanium earring was inserted at the time of the piercing. The patient resumed swim-ming 1 week after the piercing. She swam in the Gulf of Thailand, just off the coast of Koh Pha Ngan, and then went swimming again in Lac La Ronge, Sask.Two weeks after the piercing, after the patient swam in Thailand but before she swam in Saskatchewan, the ear became painful. The patient visited a physician in Canada 3 weeks after the piercing, with erythema and purulent discharge. The earring was removed and a 7-day course of cephalexin (500 mg 4 times daily) was prescribed on the presumption that
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