Perichondritis: What It Is and How It Is Treated

Written by Medicover Team and Medically Reviewed by Dr Shashi Kiran Somala , ENT

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Perichondritis is inflammation or infection of the perichondrium, the fibrous tissue surrounding cartilage. It most commonly affects the cartilage of the outer ear (pinna), although it can occur in other cartilaginous areas. The perichondrium supplies nutrients and oxygen to the cartilage, so infection or inflammation in this tissue can interfere with cartilage healing.

Perichondritis may develop after an ear injury, cartilage piercing, surgery, or bacterial infection. Because cartilage has a limited blood supply, infections affecting the perichondrium can be difficult to treat and may lead to abscess formation or cartilage damage if treatment is delayed.

What are the Symptoms of Perichondritis?

Perichondritis symptoms can develop gradually or worsen quickly, particularly when an infection is present. The condition commonly affects the cartilage of the outer ear while the earlobe is often spared.

Pain and tenderness: The affected part of the ear may become painful, especially when touched or pressure is applied.
Redness and swelling: The skin over the affected cartilage may become red and swollen.
Warmth: The affected area may feel warmer than the surrounding skin because of inflammation.
Fever: Fever may occur when the infection is more severe or has spread.
Pus or discharge: An abscess may develop and cause pus to collect or drain from the affected area.
Ear deformity: Severe or untreated infection can damage the cartilage and cause permanent changes in the shape of the ear.

Early treatment can help control the infection and reduce the risk of cartilage damage and permanent deformity.

What are the Causes of Perichondritis?

Perichondritis is commonly caused by bacterial infection that enters through damaged skin around the cartilage. Trauma, piercings, and surgical procedures can create an opening through which bacteria can enter the perichondrium.

Ear piercings: Cartilage piercings, particularly those involving the upper ear, can increase the risk of infection.
Physical trauma: Cuts, burns, insect bites, or blunt injuries can damage the skin and allow bacteria to enter.
Surgical procedures: Infection after ear surgery or other procedures involving cartilage may cause perichondritis.
Bacterial infection: Organisms such as Pseudomonas aeruginosa and Staphylococcus aureus are common causes.
Underlying conditions: Diabetes, weakened immunity, and some chronic skin conditions may increase susceptibility to infection and delay healing.

When to See a Doctor?

Seek ENT Doctor medical attention if you develop pain, redness, swelling, or tenderness of the outer ear, particularly after an injury, piercing, or surgical procedure.

Pain, redness, or swelling involving the outer ear
Tenderness or warmth around the ear cartilage
Persistent or worsening inflammation after an injury or piercing

Get medical help immediately if:

Fever with increasing ear pain or swelling
Pus, discharge, or a suspected abscess around the ear
Rapidly worsening swelling or signs of cartilage damage

Prompt evaluation and treatment can help prevent the infection from progressing and reduce the risk of permanent ear deformity.

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How Is Perichondritis Diagnosed?

Perichondritis is usually diagnosed through a physical examination and review of the patient's medical history. A healthcare provider examines the ear for redness, swelling, tenderness, warmth, abscess formation, and changes in the shape of the ear.

The healthcare provider may also ask about recent ear piercings, injuries, surgery, infections, and underlying medical conditions.

Physical examination: The ear is examined and palpated to assess inflammation, tenderness, deformity, and possible abscess formation.
Medical history: Recent trauma, piercings, surgery, infections, and underlying conditions are reviewed.
Laboratory culture: If pus or discharge is present, a sample may be collected to identify the causative bacteria and guide antibiotic treatment.
Imaging: Ultrasound or other imaging may be considered when an abscess or deeper tissue involvement is suspected.

Accurate diagnosis helps determine the severity of the infection and the most appropriate treatment.

What are the Treatment Options for Perichondritis?

Treatment for perichondritis focuses on controlling infection, reducing inflammation, relieving symptoms, and preventing cartilage damage. Treatment depends on the severity of the condition and whether an abscess or cartilage necrosis is present.

Antibiotic Therapy

Antibiotics are commonly used when perichondritis is caused by a bacterial infection. The choice of antibiotic depends on the suspected or confirmed bacteria and the severity of the infection.

Oral antibiotics: May be used for suitable mild to moderate infections.
Intravenous antibiotics: May be required for severe infections or when there are signs of systemic infection.
Targeted antibiotic therapy: Treatment may be adjusted according to culture and sensitivity results.

Surgical Treatment

Surgical treatment may be required when an abscess, infected tissue, or significant cartilage damage is present.

Abscess drainage: Pus may be drained to control infection and relieve pressure.
Debridement: Damaged or dead tissue may need to be removed when significant tissue necrosis is present.
Reconstructive surgery: Severe cartilage damage or permanent ear deformity may require corrective procedures.

Supportive Care

Pain management: Appropriate pain-relieving medicines may help reduce discomfort.
Local care: Keeping the affected area clean and avoiding further trauma can support healing.
Follow-up: Regular medical review helps confirm that the infection is resolving and allows complications to be treated promptly.

Following the prescribed treatment and completing the recommended follow-up are important for preventing recurrence and long-term cartilage damage.

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What are the Complications of Perichondritis?

Untreated or severe perichondritis can damage the cartilage and lead to complications such as:

Cartilage necrosis: Severe infection can cause death of the cartilage tissue.
Abscess formation: Pus may collect between the cartilage and surrounding tissue.
Permanent ear deformity: Cartilage destruction can permanently change the shape of the outer ear.
Spread of infection: In severe cases, infection may extend into surrounding tissues or cause systemic infection.

How Can Perichondritis Be Prevented?

Preventive measures focus on reducing the risk of ear trauma and bacterial infection.

Maintain good hygiene when caring for ear piercings.
Seek proper medical care for ear injuries, cuts, or burns.
Avoid unnecessary trauma or pressure to the ear cartilage.
Follow appropriate aftercare instructions after ear surgery or cartilage piercing.
Manage underlying conditions that may impair immunity or wound healing.