Presentation
Pseudomonas is common causative agent and when present can be associated with a more advanced clinical presentation and a longer hospitalization.[ 4 ] There may be no evident inciting cause, as in this case presentation. [ncbi.nlm.nih.gov]
SAXENA, MD, PHD, and MIKAYLA SPANGLER, PHARM D, BCPS Case Presentation A 26-year-old female presented with complaints of a swollen right pinna for 2 weeks. The swelling progressively worsened over time. [jucm.com]
Staphylococcus aureus and Pseudomonas aeruginosa are the most common bacteria. 1 The use of guns for piercing cartilage presents an additional risk of perichondritis. [pmj.bmj.com]
Presentation [ edit ] Intense pain in auricle. Auricles become red and thick. Body temperature rises. In serious cases pus appears between the perichondrium and cartillage. Purulent melting of auricular cartilage takes place. [en.wikipedia.org]
Entire Body System
- Swelling
The resulting infection produces swelling which can be severe, and can lead to focal ear necrosis. [ncbi.nlm.nih.gov]
Symptoms include redness, pain, fever, swelling of the earlobe and pus accumulation between the cartilage and the layer of connective tissue around it. [malacards.org]
Redness Pain Swelling Fever Pus Sometimes, perichondritis can lead to an infection of the cartilage, known as chondritis, which can lead to permanent damage of the ear’s structure. [specsavers.co.uk]
The swelling progressively worsened over time. In addition, she also complained of severe pain of the right pinna, with an intensity of 7/10, with no radiation and no aggravating or relieving factors. [jucm.com]
Perichondritis may be manifested by the following common symptoms: Redness Swelling Pain Pus or other fluid discharge (in severe cases) Fever (in severe cases) Deformation of the ear structure (in severe cases) If you are experiencing relapsing perichondritis [verywellhealth.com]
- Inflammation
[…] wound or the spread of inflammation into depth. [2] It may lead to severe deformation of the pinna if not treated vigorously with IV antibiotics. [en.wikipedia.org]
Perichondritis, rare inflammation of the perichondrium, the membrane that covers the cartilage of the outer ear. Perichondritis may result from swimming in contaminated water or from injury. [britannica.com]
Recent studies have also shown success with the newly developed method of aspiration, injection of streptomycin and hyaluronidase directly into the infected site, and finally triamcinolone to restrict inflammation.2 Complications If antibiotics are taken [jucm.com]
Perichondritis or perichondral inflammation is a severe and recently very frequent complication. The characteristic sign is ear pinna redness, except for the ear lobe (does not have cartilage). Pain, usually intense, may co-exist with fever. [bjorl.org]
- Surgical Procedure
It may also follow a surgical procedure such as radical mastoidectomy, or it may occur as a complication of cauliflower ear. [britannica.com]
Pseudomonas strains, present in most of the exudative material cultures, are still very much sensitive to quinolones, which makes oral treatment an accessory to the surgical procedure. [bjorl.org]
- Severe Pain
In addition, she also complained of severe pain of the right pinna, with an intensity of 7/10, with no radiation and no aggravating or relieving factors. [jucm.com]
Ears
- Otalgia
Patients initially experience dull pain, which gradually develops into severe otalgia with a purulent discharge ( Noel 1989 ). Early cases are marked by erythema, swelling, and tenderness of the auricle without notable fluctuance (Chun 2013). [rebelem.com]
Workup
Microbiology
- Pseudomonas
Also known as: perichondritis infection, Pseudomonas aeruginosa infection. What is perichondritis? The perichondrium is a thin dense layer of tissue that surrounds cartilage and which provides it with nutrients. [nicklauschildrens.org]
The most common microorganism responsible for perichondritis is Pseudomonas Aeruginosa, a gram-negative rod with intrinsic antibiotic resistance mechanisms ( Caruso 2014 ) ( Wu 2011 ). [rebelem.com]
The most commonly found pathogen is Pseudomonas aeruginosa, together with Staphylococcus aureus 6. [bjorl.org]
Abstract Purpose Pseudomonas aeruginosa is commonly found in suppurative perichondritis, but the significant pathogens in non-abscess perichondritis are unclarified. [springermedizin.de]
Antibiotics coverage should be targeted to cover skin flora and Pseudomonas, and if an abscess is present, surgical drainage is also recommended to prevent ear disfigurement. [ncbi.nlm.nih.gov]
- Staphylococcus Aureus
The most commonly found pathogen is Pseudomonas aeruginosa, together with Staphylococcus aureus 6. [bjorl.org]
Staphylococcus aureus and Pseudomonas aeruginosa are the most common bacteria. 1 The use of guns for piercing cartilage presents an additional risk of perichondritis. [pmj.bmj.com]
P. aeruginosa was recovered in 58% of abscess cases, while Staphylococcus aureus was predominant in non-abscess infections (49%). Eighty-two percent of S. aureus recovered were isolated as heavy or moderate growth. [springermedizin.de]
Staphylococcus aureus, Escherichia coli and Proteus species, with P. aeruginosa being the most common culprit.3 Perichondritis is usually a result of secondary infection of the ear after traumatic injury. [jucm.com]
Treatment
The human pinna receives less humoral circulation which can lead to treatment failure and progression of the disease.[ 5 ] Treatment however, consists of antibiotics and, if an abscess is present, surgical drainage. [ncbi.nlm.nih.gov]
Perichondritis treatment Early treatment is important in order to reduce the chance of the infection spreading to the cartilage which could damage the structure of the ear. [specsavers.co.uk]
Treatment Treatment consists of broad antibiotic coverage, either by mouth or directly into the bloodstream via an intravenous line. [jucm.com]
[…] for Perichondritis Treatment for your perichondritis will be based on your physical examination. [verywellhealth.com]
Treatment Treatment consists of antibiotics, either by mouth or directly into the bloodstream through an intravenous (IV) line. If there is a trapped collection of pus, you may need surgery. [account.allinahealth.org]
Prognosis
Outlook (Prognosis) How well a person does depends on how quickly the infection is diagnosed and treated. If antibiotics are taken early, full recovery is expected. If the infection involves the ear cartilage, more involved treatment is needed. [account.allinahealth.org]
Prognosis of perichondritis is good if treated promptly; a full recovery is typically expected. Thanks for your feedback! Brant, JA & Ruckenstein, MJ. (2015). [verywellhealth.com]
Etiology
METHODS: We retrospectively studied 114 patients who were admitted with perichondritis during 1987-2004, including their demographic details, medical history, current illness, etiology, pathogens and treatments. [ncbi.nlm.nih.gov]
Stell, PM, Morrison, MD: Radiation necrosis of the larynx, etiology and management. Arch Otolaryngol 98: 111 – 113, 1973. Google Scholar | Medline 6. Goodrich, WA, Lenz, M: Laryngeal chondronecrosis following roentgen therapy. [journals.sagepub.com]
No traumatic etiology was identified. [rebelem.com]
Prevention
If so, plastic surgery will be needed to restore the ear to its normal shape.2-4 Prevention The best way to prevent perichondritis is to avoid pierc- ing one’s ear through the cartilage, as opposed to the ear lobe. [jucm.com]
After removing the damaged parts of the ear, the plastic surgeon can reconstruct the removed portion in order to cosmetically restore the removed portions of your ear Preventing Perichondritis Sometimes perichondritis cannot be prevented, such as in the [verywellhealth.com]
Prevention Avoid piercing your ear through the cartilage. Piercing the ear lobe is a better option. The popularity of cartilage piercing has led to a significant increase in the number of perichondritis and chondritis infections. [account.allinahealth.org]