Perichondritis

      Perichondritis, an infection of the perichondrium of the auricular cartilage, typically follows local trauma (e.g., ear piercing, burns, or lacerations). Occasionally, when the infection spreads down to the cartilage of the pinna itself, patients may also have chondritis. The infection may closely resemble auricular cellulitis, with erythema, swelling, and extreme tenderness of the pinna, although the lobule is less often involved in perichondritis. The most common pathogens are P. aeruginosa and S. aureus, although other gram-negative and grampositive organisms are occasionally involved. Treatment consists of systemic antibiotics active against both P. aeruginosa and S. aureus. An antipseudomonal penicillin (e.g., piperacillin) or a combination of a penicillinase-resistant penicillin plus an antipseudomonal quinolone (e.g., nafcillin plus ciprofloxacin) is typically used. Incision and drainage may be helpful for culture and for resolution of infection, which often takes weeks.

Source: harrison_s_principles_of_internal_medicine_16th_edition