Perichondritis is an ear infection, which may cause intense pain in the ears along with fever.
The external ear or the pinna, which is the part that sticks out to the side of the head, is a made up of skin and cartilage. Cartilage is the thick tissue that creates and maintains the shape of the nose and the outer ear. Perichondrium is a thin layer beneath the skin that covers the cartilage. It provides nutrients and oxygen to the underlying cartilage.
An infection of the perichondrium layer around the cartilage of the external ear (or the pinna) is known as Perichondritis. Infection usually occurs after an injury. For example, it may occur after ear piercing, a surgery or an accident.
Your body part that Perichondritis affects
Upper and middle parts of the external ear (pinna) that are made up of the cartilage are affected. There is no hearing loss. However, there may be fever and intense pain in the ear.
Causes of Perichondritis
Perichondritis mostly occurs due to an infection to the external ear by bacteria. Normally the skin overlying the ear cartilage does not allow bacteria to reach the perichondrium. Damage to the overlying skin due to any type of injury allows bacteria to reach the perichondrium layer. This results in inflammation, swelling and damage to the perichondrium layer. Damage to perichondrium reduces blood supply to the ear cartilage which causes further damage. An injury to the external ear may occur due to:
- Ear Piercing: People who get their ears pierced have higher chances of developing Perichondritis. The chances are still higher if the piercing is done in the region of ear cartilage (high piercing). Perichondritis usually occurs because of unclean instruments used for piercing. It may also occur due to improper care after piercing. People having multiple piercings done at a single time have higher chances of developing Perichondritis.
- Sports or Accidents: The external ear may be injured in games such as cricket, hockey or football. Accidents may also cause an injury. People who had burns on the ear also have higher chances of infection.
- Surgery: A recent ear surgery may increase the chances infection to the perichondrium layer.
- Acupuncture: Acupuncture involves piercing needles into several parts of the body for relief from pain or other disorders. Piercing in or around the ear with unclean needles may cause Perichondritis.
- Associated Ear Infections: An infection from the outer ear canal (as in Otitis Externa) or from a boil may also spread to the perichordrium.
Chances of Perichondritis are higher in people who have a weak immune system such as in old people or in people who have diabetes or HIV.
Symptoms of Perichondritis
The usual symptoms are redness, swelling and pain in the external ear
. The pain can be intense. A watery fluid may ooze out from the infected area initially, which may be followed later by a greenish-yellow fluid (pus) discharge. There may be fever also.
Tests and diagnosis of Perichondritis
Any history of recent piercing, injury or a surgery to the ear is verified. An examination of the external ear to look for presence of redness, swelling or discharge is also conducted.
Additionally following tests may be done to confirm the diagnosis:
Treatment for Perichondritis
- A sample of the discharge coming out of the infected site is collected and stained using several chemicals to analyze it under a microscope. The sample may be kept along with certain chemicals that promote the growth of microorganisms. This helps to identify the type of the organism that has infected. It also helps to choose an appropriate drug which will be more effective in killing the infective organism.
- Blood sugar may be tested to check for diabetes.
The aim of treatment is to relieve the symptoms, cure the infection and to prevent complications.
The infected region should be kept clean. It should be washed with warm water regularly. This not only keeps the area clean but also helps in removing the discharge from the infected site.
Pain-killers such as acetaminophen
may be given to relive pain. Antipyretics such as paracetamol may also be given to relieve fever, if present.
Antibiotics are given to kill the infective microbes. They may be given orally or injected directly into the blood vessels. Antibiotics may be needed for several days for complete cure.
Surgery may be needed to remove excessive pus or fluid accumulated in the wound. A small cut is made on the overlying skin using a blade and the accumulated pus is removed. This helps in early healing of the infection.
In severe cases, a part of the ear may become dead which has to be removed by surgery. In such cases, plastic surgery
may be done after the infection heals, to reconstruct the ear and regain its normal appearance.
Prevention of Perichondritis
One may prevent Perichondritis by:
- Avoiding ear piercing, especially to the upper or the middle part of the external ear (Pinna). Also multiple ear piercings in a single sitting should be avoided.
- Avoiding injuries to the ear. Wearing a helmet while driving a motor bike or while playing sports such as cricket protects the ears.
- Using only clean and unused needles if having acupuncture.
- Treating any ear infections appropriately and in time.