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Contributors: Casey Silver MD, Benjamin L. Mazer MD, MBA, Michael W. Winter MD
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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.


H61.009 – Unspecified perichondritis of external ear, unspecified ear

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)
  • Ramsay-Hunt syndrome – 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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Last Reviewed:03/28/2019
Last Updated:04/01/2019
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A medical illustration showing key findings of Perichondritis : Edema, Erythema, Helical rim of ear, Tragus of ear
Clinical image of Perichondritis - imageId=7407461. Click to open in gallery.
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