Auricular perichondritis

Perichondritis may complicate any external ear trauma. It is a serious condition and need to be treated with full respect. Once developed, perichondritis rapidly spread to involve the whole pinna sparing only the ear lobule (as the lobule has no cartilage). The patient will have severe pain and itchiness in the affected ear. Prompt treatment with antibiotics that cover both Gram-positive and Gram-negative organisms (especially pseudomonas) should be started without delay. Less severe cases may be treated as outpatient with a course of quinolones (e.g. ciprofloxacin). More severe cases should be admitted to hospital and treated with intravenous antibiotics. Again, quinolones or combination of a second-generation cephalosporin and an aminoglycoside is a good alternative. Further antibiotic treatment should be guided by the result of culture and sensitivity tests. Antibiotics should be given till all signs of infections have subsided. If abscess develops during therapy, this should be incised and drained immediately. The cavity irrigated with aminoglyco-side solution to treat or prevent pseudomonas infection. Once becomes clean, the cavity should be closed by pressure dressing applied to conform with the contour of the pinna. Some deformity is often inevitable, however, with prompt and proper treatment a cauliflower ear should be avoidable.

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