Perichondritis
Perichondritis is a small exquisitely tender node sometimes forms on the helix of the pinna of the ear which makes it impossible to sleep lying on the affected side. It is caused by chronic infection secondary to minor trauma and may be helped by a topical antibiotic such as Mupirocin or Fusidic Acid. Lacerations of the pinna can progress to severe chondritis
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or perichondritis and so must be fully treated by suturing and antibiotics such as Penicillin plus Flucloxacillin, Co-amoxyclav or Erythromycin.
Perichondritis is usually incited by blunt trauma to the external ear. It presents with marked ear tenderness and overlying soft tissue swelling. The blood supply to the ear cartilage is somewhat fragile and bacterial infections can spread rapidly in this area. If medical attention is not sought, cartilage necrosis with long-term ear deformity may occur. Recurring infections and cartilage deformation are common in boxers and is known as "cauliflower" ear.
If the diagnosis is made rapidly and antibiotics are started, then full recovery is expected. In more advanced cases, when the infection involves the ear cartilage (chondritis), part of the ear may die and need to be surgically removed. This may result in the need for plastic surgery to restore the ear to its normal shape. The outer ear, the part that sticks out from the side of your head, is a structure made almost exclusively out of skin and cartilage, a stiff material that allows the ear to keep its shape.
All cartilage has a thin layer of tissue around it, called perichondrium, which helps to provide nutrients to the cartilage. Infection of this thin tissue, termed perichondritis, is usually caused by trauma to the ear, either accidental or as a result of ear surgery, ear piercing (especially piercing of the cartilage), or contact sports. Ear piercing through the cartilage is probably the most significant risk factor today. The most common bacteria causing this infection are called Pseudomonas aeruginosa. While not a common infection, perichondritis can cause severe damage to the ear if it progresses to chondritis. |
