Auricular perichondritis

Background

Ear anatomy
  • An infection of the connective tissue of the ear that covers the auricle or pinna
    • Typically does not involve the lobule
    • Misnomer as the cartilage is almost always involved with abscess formation and cavitation
  • May be a devastating disease if improperly treated
    • can lead to liquefying chondritis
  • Most common causes include minor trauma, burns, and ear piercing
    • growing incidence may be related rising popularity of high chondral ear piercings
    • May be a presenting symptom of immunosuppresion
  • The most common microorganism responsible for perichondritis is Pseudomonas Aeruginosa

Clinical Features

Perichondritis of the pinna.
  • Initially presents with dull pain, progresses to severe otalgia
  • Purulent discharge
  • Erythema, swelling, tenderness of the auricle without notable fluctuance
  • No involvement of the lobule which distinguishes it from otitis externa

Differential Diagnosis

Ear Diagnoses

External

Internal

Inner/vestibular

Evaluation

  • Diagnosis is made clinically by thorough physical exam
    • Exam should include evaluation of mastoid process, temporal bone, facial bones, orbital bones, and middle ear

Management

  • Antipseudomonal antibiotic therapy
  • Consider incision and drainage by ENT

Disposition

  • May discharge home for outpatient treatment
    • consider specialist evaluation and hospital admission if abscess or necrosis are suspected

See Also

External Links

References