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Perichondritis

By

Bradley W. Kesser

, MD, University of Virginia School of Medicine

Last full review/revision Sep 2020| Content last modified Sep 2020
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Perichondritis is infection of the tissue covering the cartilage of the external part of the ear called the auricle (pinna).

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.

Treatment

  • Antibiotics and corticosteroids

  • Removal of foreign objects, especially ear piercings through the cartilage part of the auricle

  • Warm compresses and incision and drainage of abscesses

  • Pain relievers

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.

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