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Background
- An infection of the connective tissue of the ear that covers the auricle or pinna
- Misnomer as the cartilage is almost always involved with abscess formation and cavitation
- Typically does not involve the lobule since this contains no cartilage
- 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 immunosuppression
- 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
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 if mild
- Consider specialist evaluation and hospital admission if abscess or necrosis are suspected
See Also
External Links
References
