Perichondritis
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Synopsis

Perichondritis is an infection of the soft tissue that encloses the auricular (ear) cartilage. It typically presents with erythema, edema, and tenderness in the pinna of the ear. Infection is usually bacterial, introduced through local trauma (ie, piercing) or burns. Pseudomonas aeruginosa and Staphylococcus aureus are the bacteria most commonly implicated, and polymicrobial infection is common. Immunocompromised patients are at increased risk for perichondritis. Perichondritis can be the presenting infection of human immunodeficiency virus, lymphoma, and, in some instances, diabetes mellitus.
Relapsing polychondritis is a rare noninfectious disorder that mimics perichondritis.
Perichondritis is treated with systemic antibiotics that include both pseudomonal and staphylococcal coverage. If untreated, infection may spread into the deeper cartilage of the ear (chondritis), causing more significant injury.
Relapsing polychondritis is a rare noninfectious disorder that mimics perichondritis.
Perichondritis is treated with systemic antibiotics that include both pseudomonal and staphylococcal coverage. If untreated, infection may spread into the deeper cartilage of the ear (chondritis), causing more significant injury.
Codes
ICD10CM:
H61.009 – Unspecified perichondritis of external ear, unspecified ear
SNOMEDCT:
37600001 – Perichondritis
H61.009 – Unspecified perichondritis of external ear, unspecified ear
SNOMEDCT:
37600001 – Perichondritis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Relapsing polychondritis – This does not spare the earlobe and will not respond to antibiotics. It may be diagnosed with biopsy.
- Neoplastic disease – Uncommon, but should be considered when symptoms include otalgia and nonhealing cutaneous lesions.
- Auricular hematoma (see chronic hematoma of pinna)
- Herpes zoster oticus – May have vesicular lesions.
- Allergic angioedema – Usually painless.
- Juvenile spring eruption – A sun reaction, usually bilateral, that may present in conjunction with plaques on the face or dorsal hands.
- Environmental injuries (see frostbite and sunburn)
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Management Pearls
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Therapy
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References
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Last Reviewed:03/28/2019
Last Updated:04/01/2019
Last Updated:04/01/2019