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Auricular perichondritis is a bacterial infection of the overlying skin and perichondrium of the ear, by definition sparing the auricular cartilage. It may be an extension of OE. Causative organisms include P aeruginosa, S aureus, and S pyogenes. Predisposing factors include surgery, ear piercing, burns, frostbite, insect bites, and contact sports. Clinical findings include a swollen, tender, erythematous, and warm auricle, which may involve the ear lobule, and often a fever; the TM is unaffected. Infectious perichondritis may be confused with relapsing polychondritis, an autoimmune condition involving the cartilage of the ears, nose, and trachea.
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Management and Disposition
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Institute oral antibiotics with Pseudomonas coverage and follow up in 48 hours; however, hospitalization is often required for parenteral antibiotics in children and immunocompromised or diabetic patients. Topical antibiotic otic drops should be used if OE is present.
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P aeruginosa is the most common bacteria causing auricular perichondritis.
Ear piercing is the most common activity resulting in auricular perichondritis.
Fluctuance and auricular deformity suggest auricular chondritis, a frequent complication of perichondritis.
Consult ENT for abscess drainage to limit permanent ear disfigurement.
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