An infection of the skin and layer of tissue around the cartilage of the external ear. When the infection involves the cartilage, the disease is called chondritis.

Causes, incidence, and risk factors

The outer ear, the part that sticks out from the side of your head, is a structure made almost exclusively out of skin and cartilage, a stiff material that allows the ear to keep its shape. All cartilage has a thin layer of tissue around it, called perichondrium, which helps to provide nutrients to the cartilage. Infection of this thin tissue, termed perichondritis, is usually caused by trauma to the ear, either accidental or as a result of ear surgery or ear piercing (especially piercing of the cartilage). Ear piercing through the cartilage is probably the most significant risk factor today. The most common bacteria causing this infection are called Pseudomonas aeruginosa . While not a common infection, perichondritis can cause severe damage to the ear if it progresses to chondritis.

Signs and tests

The diagnosis of perichondritis is usually made by history and physical exam. If there is a history of trauma to the ear and the ear is red and very tender, then the presumed diagnosis is perichondritis.

Treatment

Treatment consists of antibiotics, either by mouth or directly into the blood stream through an intra-venous line (IV). If there is a trapped collection of pus, then surgery may be necessary to drain this fluid and remove any dead skin and cartilage.

Expectations (prognosis)

If the diagnosis is made rapidly and antibiotics are started, then full recovery is expected. In more advanced cases when the infection involves the ear cartilage (chondritis), then part of the ear may die and need to be surgically excised resulting in a cosmetic deformity of the ear that may need plastic surgery to reconstruct.

Complications

The main complication is extension of the infection into the cartilage of the ear that can lead to death of part of the cartilage that would then have to be removed.

Calling your health care provider

If you suffered any trauma to your ear (a scratch, blow, piercing…) followed by the development of pain and redness over the stiff part of the ear (not just the floppy ear lobe), then contact your health care provider for evaluation. You may need to start antibiotic treatment.

Prevention

The best way to prevent this infection is to avoid ear piercing through the cartilage (not the ear lobe). Since this practice has become more popular, there has been a significant increase in the number of cases of perichondritis and chondritis.