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
      • HIV, diabetes, Non-Hodgkin's lymphoma, or relapsing polychondritis
  • 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


References
    This article is issued from Wikem. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.