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What Is Perichondritis?

Medically Reviewed by Jabeen Begum, MD on August 24, 2022

Perichondritis is an infection that occurs in the tissue of the cartilage located in your outer ear, which is called the auricle or pinna. The infection itself is sometimes referred to as auricular perichondritis or pinna perichondritis, though that’s often simplified to just perichondritis. 

Thankfully, perichondritis isn’t known to be a common infection, though researchers are unsure of the exact number of people who have experienced this infection. The greatest risk factor for getting perichondritis is receiving an ear piercing that is high up rather than one on your earlobe. 

Since this type of piercing has become more common, it is expected that cases have doubled, especially in the years between 1990 and 1998. 

Perichondritis Causes

Perichondritis occurs as the result of a bacterial infection. The most common bacteria that causes perichondritis is known as Pseudomonas aeruginosa. Other, less common bacteria that can cause perichondritis include Staphylococcus and Escherichia coli

The main cause of perichondritis is injury or trauma to the ear. Bacteria enter this point of injury or trauma, usually around the cartilage of your outer ear. The most common causes of such ear injuries are high ear piercings that enter through your cartilage. These types of piercings can cause damage to your cartilage and can allow bacteria in. 

Piercings aren’t the only cause of perichondritis, though. The other causes include: 

  • Head trauma, especially to the side of your head
  • Contact sports 
  • Burns 
  • Insect bites
  • Acupuncture
  • Ear surgery 
  • Ear infections that have been left untreated 
  • Minor trauma
  • A shingles infection 

Certain individuals may be at a higher risk of contracting perichondritis. These individuals include: 

  • Those with inflammatory disorders 
  • Those who are immunocompromised
  • People with diabetes 

Perichondritis Symptoms

An outer ear that is painful to the touch and is red and swollen is the main symptom of perichondritis. The redness usually occurs around an injury sustained to the ear, such as a cut, bite, scrape, or piercing. Perichondritis most commonly affects the upper part of your outer ear and rarely affects your earlobe. 

If there is an abscess present, it’s likely that you’ll experience some fluid drainage as well. A fever, tenderness, and a warm feeling in your ear are also symptoms of perichondritis.

Diagnosing Perichondritis

Your doctor will look over your medical history and then examine the infected ear. They will ask about any recent trauma to the ear and will look for any changes in the shape of your ear. If the ear is red and tender, then your doctor will likely diagnose you with perichondritis. 

Perichondritis Treatment

Antibiotics are the main treatment method for perichondritis. The kind of antibiotics given will depend on how severe the infection is, as well as the type of bacteria involved. Fluoroquinolone is the most common antibiotic prescribed for treating perichondritis and comes in two forms: oral and tropical. 

Children’s treatment plans may differ, though, as fluoroquinolone may not always be an option for adolescents. Some research has suggested that fluoroquinolone may cause stiff joints and tears in the tendon in children, although the American Academy of Pediatrics, or AAP, has cleared this antibiotic as being safe for children. 

During your visit to your doctor, they will remove all foreign objects from your ear, including splinters and cartilage ear piercings. Besides an antibiotic prescription, they may also suggest that you take an oral corticosteroid, take over-the-counter pain relievers, and apply a warm compress to the affected area. 

If an abscess is present, surgery may be required. This is because the abscess, which contains a collection of pus, can limit the blood supply to your cartilage. If surgery is needed, a small incision will be made in the abscess. This will allow the pus to drain and for your doctor to remove dead cartilage and skin. Following this, blood will be able to flow normally to your cartilage once more. 

Your doctor may place a small drain inside your ear for up to three days. To keep your blood flowing to your cartilage, they may also stitch your cartilage and tissue together. 

Perichondritis Prognosis

The outlook for perichondritis is generally favorable as long as the infection is caught and treated early. With early antibiotic treatment, you can expect a full recovery. 

However, if the infection has gone untreated, involves the ear cartilage, or produces an abscess, further treatment may be required. 

For those who have received a quick diagnosis and treatment, symptoms should clear up within three days. Discomfort is usually the last symptom to go and could last for a month. 

If surgery is required, you’ll have to dress your wound appropriately and take appropriate measures to ensure that your surgical site remains clean to allow it to properly heal. 

Perichondritis Complications

An abscess that is left untreated could lead to the destruction of your cartilage, as well as dead tissue. If this happens, you may develop a deformity of your ear known as cauliflower ear. This may require cosmetic surgery to repair. 

Another complication of perichondritis is developing a secondary infection in your ear cartilage known as chondritis. This infection can result in the structure of your ear becoming severely damaged. As a result, part of the tissue of your ear could die and require surgery to remove. If this happens, ear reshaping surgery may be required in order to return your ear to its normal shape. 

Perichondritis Prevention

The main step in perichondritis prevention is to avoid receiving piercings in your upper ear. Piercings in the earlobe have a much lower risk of infection. If you do decide to pierce your upper cartilage, then taking proper care of the piercing is a must.

Other preventive measures include: 

  • Avoiding ear-related acupuncture 
  • Receiving proper and prompt treatment for ear infections
  • Avoiding participating in contact sports
  • Avoiding excessive ear scratching 

When to Call a Doctor

Treating perichondritis early is crucial to a full recovery and lack of complications. So, if you notice any pain, redness, or swelling around your outer ear, you should consult your doctor immediately. 

Show Sources

SOURCES: 

Boston Children's Hospital: “Perichondritis.”

Cleveland Clinic: “Perichondritis.”

Mount Sinai: “Perichondritis.”

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