Injuries, burns, insect bites, ear piercings through the cartilage, ear surgery, or a boil on the ear may cause perichondritis. The infection also tends to occur in people who have inflammatory disorders, such as granulomatosis with polyangiitis, whose immune system is weakened, or who have diabetes.
The first symptoms are redness, pain, and swelling of the auricle. The person may have a fever. Pus accumulates between the cartilage and the layer of connective tissue around it (perichondrium). Sometimes the pus cuts off the blood supply to the cartilage, destroying it and leading eventually to a deformed ear (called cauliflower ear). Perichondritis can be destructive, recur, and last a long time.
Doctors treat perichondritis with antibiotics (such as a fluoroquinolone, for example, ciprofloxacin) and often a corticosteroid by mouth. The choice of antibiotic depends on how severe the infection is and which bacteria are causing it.
Doctors remove any foreign objects, such as an earring or a splinter.
If people have an abscess (collection of pus), doctors make an incision to drain the pus, allowing blood to reach the cartilage again, and leave a small drain in place for 24 to 72 hours. Antibiotics are given by mouth. Warm compresses may also help. Doctors may stitch (suture) the perichondrium to the cartilage to ensure that it heals correctly to avoid a deformity of the auricle.
Pain relievers are also given.