Pericondrite

Pericondrite, also called perichondritis, is an inflammatory condition of the perichondrium, the connective tissue layer surrounding cartilage. The disease most often involves cartilaginous structures in the head and neck, such as the external ear (auricular perichondritis) and nasal cartilage. Cartilage itself is avascular and relies on the perichondrium for blood supply; inflammation of this layer can compromise nourishment to the cartilage and, if untreated, lead to cartilage necrosis and deformity.

Most cases are infectious in origin. Common pathogens include Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus species. Noninfectious causes are less frequent and may be linked to inflammatory or autoimmune processes. Risk factors include trauma or procedures involving cartilage (for example, ear piercing, ear trauma, burns) and, in some cases, compromised immunity.

Clinical features typically include localized pain, swelling, redness, and warmth over the affected cartilage. In auricular perichondritis, the earlobe may be spared, and there may be tenderness with movement of the pinna. Fever or malaise can occur. Nasal or other cartilaginous sites may show similar symptoms and potential deformity if advancing.

Diagnosis is usually clinical, supported by history and examination. Microbiological cultures can guide antibiotic choice. Imaging (such as ultrasound, CT, or MRI) may be used if an abscess or deep infection is suspected. Laboratory tests may reveal elevated inflammatory markers.

Treatment requires appropriate antibiotics with activity against Pseudomonas and common skin flora. Options include oral ciprofloxacin or intravenous anti-pseudomonal agents (e.g., piperacillin-tazobactam, ceftazidime) with coverage for Staphylococcus. Remove any contributing jewelry or hardware, and consider drainage if an abscess forms. Prognosis is good with prompt therapy, but delayed treatment risks cartilage necrosis and deformity.