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Background: Suppurative perichondritis of the auricle is a common disease that can easily cause malformations if it develops into an uncontrolled infection. In nearly half of the cases, otolaryngologists cannot identify the pathogens involved., Case Presentation: In the present work, we described two cases of pyogenic perichondritis, with negative on conventional culture. However, using metagenomic next-generation sequencing (mNGS), we detected fungal infections in the patients and after the patients were given anti-fungal treatment, the patients achieved a good prognosis., Conclusions: These cases highlighted the possibility that fungi might be the involved pathogens in patients who have had multiple negative bacterial cultures, and mNGS should be applied in these cases. mNGS could be used as a supplement to traditional culture methods., (© 2024. The Author(s).)

Objectives/hypothesis: The purpose of this systematic review was to critically analyze infectious complications and treatment following transcartilaginous ear piercing., Data Sources: MEDLINE Pubmed database., Review Methods: A MEDLINE PubMed database search using free text, including "ear chondritis," "ear perichondritis," "ear cartilage piercing," and "auricle piercing," yielded 483 titles. Based on set inclusion and exclusion criteria, the titles, abstracts, and full text articles were reviewed for inclusion and underwent data extraction. Pooled outcomes are reported., Results: A total of 29 articles met inclusion criteria, including 66 patients. The mean age of the patients was 18.7 ± 7.6 years (range: 11-49), 87.5% female. Ear deformity was more likely to occur following postpiercing perichondritis of the scapha 100% versus the helix 43% (P = 0.003). Mean duration of symptoms prior to patients seeking medical attention was 6.1 ± 4.1 days. Greater than 5 days of symptoms prior to seeking treatment was significantly more likely to result in hospitalization. Pseudomonas aeruginosa accounted for 87.2% infections. Of the patients with Pseudomonas, 92.3% were hospitalized versus 75% of the patients infected with Staphylococcus aureus. Initial oral antibiotics prescribed did not target the cultured bacterium in 53.3% of cases; of these, 87.5% were hospitalized., Conclusions: Transcartilaginous postpiercing infection may lead to ear deformity and hospitalization. Patients (customers) and practitioners must be aware of optimal treatment strategies to minimize associated morbidity. Scapha piercing and delay in presentation are associated with poorer outcomes. Pseudomonas is the most common bacterial infection. Initial antibiotic selection must be optimized accordingly., (© 2015 The American Laryngological, Rhinological and Otological Society, Inc.)

Erythema of the ear lobe in the context of Lyme disease is caused by either borrelial lymphocytoma or localized erythema migrans. Here we present a case of chondritis limited to the ear cartilage caused by Lyme disease. The patient was treated with ceftriaxone with complete resolution of symptoms.

Background: Despite being impervious to surveillance by the adaptive immune system because of its lack of vascularity, infection of the nasal and auricular cartilage after surgery such as rhinoplasty or otoplasty is rare. Why is this so? Our goal was to determine whether the expression of antimicrobial peptides provides a previously unrecognized nonepithelial layer of innate immune defense within the nasal and auricular cartilage., Materials and Methods: Seven samples of nasal septum cartilage and 2 biopsies from auricular cartilage grafts were harvested during rhinoplasty and otoplasty procedures. Ten cadaveric samples of auricular and 9 samples of nasal cartilage were also obtained. Immunohistochemical staining was directed against the human beta-defensin antimicrobial peptides (hBD) 1, 2, and 3. A semiquantitative analysis was performed to measure immunoreactivity., Results: All 3 human beta-defensins were detected along the perichondral line and within the cartilage matrix in the nasal and auricular samples. Areas with positive immunohistochemical staining were also detected within chondrocyte cytoplasm., Conclusions: We provide the first evidence of antimicrobial peptide expression (hBD-1, -2 and -3) within the perichondrium and cartilage matrix layers of the nasal and auricular cartilage. This previously unrecognized innate immune function of perichondrocytes and chondrocytes may explain the resistance of the nasal and auricular cartilage to infection after surgical procedures despite the absence of a vascular system.

Unlabelled: Piercing has become more and more popular among adolescents. The procedure is generally performed by unqualified professionals and carries its risk. Non-sterilized material or inappropiate hygiene increases the possibility of perichondritis and celulitis. The disease is characterized by erythema of the auricula pinna, unbearable pain and fever. Left untreated, the condition progresses with edema along the auricula and abscess formation that may result in ischemic necrosis and a cauliflower anesthetic deformation. The most common bacteria is Pseudomonas aeruginosa. In cases with abscesses, drainage is necessary along with antibiotic therapy guided by cultures and antibiogram., Aim: The aim of this case report was to review the past 10 years of published papers dealing with anatomical aspects of the auricular pinna, the history of piercing and its most common complications., Methods: A case report of perichondritis after 'high' ear piercing that required surgical treatment and that progressed with no esthetic loss., Results: Theoretical and practical experience based on a review and a report of a case that progressed satisfactorily., Conclusions: The increased incidence of perichondritis in adolescents should require more elaborated primary prevention measures.

Body piercing has become a fashionable trend in western culture. High ear piercing is common among the adolescent population and complications from this procedure although uncommon can be permanently disfiguring. We describe a case of perichondritis after high ear piercing in an adolescent male. A review of the history of body piercing, complications, risk factors, and treatment is presented.

Background: Investigation and case-control study to identify risk factors in a large outbreak in 2003 of auricular chondritis associated with piercing., Methods: Epidemiologic, environmental, and laboratory (pulsed-field gel electrophoresis) investigation, and case-control study. Telephone interviews were conducted for 15 cases and 61 controls. Odds ratios were determined for risks of infection., Results: Of 15 confirmed cases, nine (60%) were hospitalized (median duration 4.4 days) and treated with intravenous/oral antibiotics. Cases required surgical treatment and multiple antibiotics. Risk factors for infection included piercing location and the use of a contaminated aftercare solution. Pseudomonas aeruginosa isolates, nine from patients and four from the aftercare solution, were indistinguishable by pulsed-field gel electrophoresis; one from the sink at the facility differed by two bands., Conclusions: This study demonstrates the serious consequences of cartilage piercing, identifies specific risk factors for infection, and suggests the importance of implementation and assurance of safe procedures.

Three cases of auricular perichondritis caused by infection with Pseudomonas aeruginosa are described to draw attention to the high incidence of piercing-related infections and the risk of structural deformities to the outer ear. Various therapies and outcomes are described and current Danish legislation is highlighted.

This paper describes five patients who had undergone transcartilaginous ear piercing and were infected with Pseudomonas aeruginosa, which led to perichondrial abscess. Early treatment of chondritis with aggressive surgical therapy combined with relevant antibiotics results in good healing and a minimal loss of cartilage. The literature review and cases presented show that piercing is not harmless and that regulation of the piercing business would seem to be desirable.

Objective: To examine the in vitro susceptibility patterns of aural isolates of Pseudomonas aeruginosa and to identify changes over a 4-year period., Design: Retrospective case series., Setting: The outpatient department at Children's Hospital of Pittsburgh (Pa), a tertiary referral center., Patients: Ambulatory children younger than 18 years from whose ears P aeruginosa was isolated., Outcome Measures: The in vitro susceptibility of aural isolates of P aeruginosa to ampicillin, cefotaxime, chloramphenicol, sulfisoxazole, ticarcillin, mezlocillin, gentamicin, tobramycin, cefazolin, tetracycline, piperacillin, nitrofurantoin, cephalexin hydrochloride, ceftriaxone, cefuroxime axetil, and sulfamethoxazole-trimethoprim., Results and Conclusions: No changes were found in the trends of the susceptibility patterns over the 4-year study period, with the exception of the semisynthetic penicillins, ticarcillin and mezlocillin. These two agents were found to be relatively ineffective against the strains of P aeruginosa isolated in 1989 (59% and 18% susceptibility, respectively). This finding is in contrast to their effectiveness over the remainder of the study period (96% and 90% susceptibility, respectively), which was excellent. These observations likely reflect a change in the breakpoints for the minimal inhibitory concentrations between these periods. The intravenous agent with the best susceptibility profile was piperacillin (96%). Of the aminoglycosides tested, 94% of the isolates were sensitive to tobramycin, as opposed to only 79% for gentamicin. This finding may have significance when one is empirically selecting ototopical therapy, since both tobramycin and gentamicin are available as topical preparations. Of the oral agents, the combination of sulfamethoxazole-trimethoprim was most effective (46%).