Acute perichondritis

Acute perichondritis

Description : Acute perichondritis of the auricle is a bacterial infection of the perichondrium and underlying cartilage which usually develops following trauma to the skin of the pinna.

A painful, red and swollen pinna following localized infection of the external ear, trauma or surgery, suggests the development of acute perichondritis.

Acute perichondritis occurs most commonly following lacerations or incisions which extend through the perichondrium.

Gram-negative bacteria, especially Pseudomonas aeruginosa and Proteus, are the usual causative organisms.

This type of acute bacterial infection is potentially serious because if untreated, the underlying auricular cartilage will become infected and ultimately necrotic with collapse of the pinna.

Treatment consists of an oral or intravenous antibiotic which is effective against Pseudomonas (pending receipt of culture and sensitivity reports) combined with a broad-spectrum antibiotic, and the topical application of local compresses of Burrow's solution.

If a subperichondrial abscess forms, then surgical incisions through the perichondrium with drainage of the infected material and the insertion of packing impregnated with an appropriate topical antibiotic will be required.

In severe cases the infection may spread to involve the outer part of the external auditory canal and radical surgery may be necessary.

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