perichondritis(pinna)

Last reviewed 01/2018

• perichondritis may be a complicaton of ear piercing
  • "high" piercing, which requires puncture through the cartilage of the upper third of the pinna may cause auricular perichondritis
    • the subperiosteal abscess which may occur with perichondritis often leads to loss of cartilage and to an unsightly deformity known as "cauliflower ear," which has a poor chance of good reconstruction
    • the usual infective agent in auricular perichondritis is Pseudomonas aeruginosa
• in the early phase of infection, treatment should focus on eradicating Pseudomonas aeruginosa and Staphylococcus aureus
  • antipseudomonal agents such as oral ciprofloxacin or intravenous ticarcillin or carbenicillin are necessary. Ciprofloxacin also has good activity against S aureus
• keep the patient under close observation
  • failure to respond to treatment requires admission as inpatient to an ear, nose, and throat department.Surgical intervention is required at the earliest sign of an abscess
• lacerations of the pinna can progress to severe chondritis or perichondritis and so must be fully treated by suturing and antibiotics such as Penicillin plus Flucloxacillin, Co-amoxyclav or Erythromycin

Reference:

1. BMJ. 2001;322(7291):906-7.