Infected transcartilaginous ear piercings. A case report and review of the literature.

Autores/as

  • Javier Ignacio Rodríguez Gutiérrez Facultad de Medicina, Pontificia universidad católica de Chile http://orcid.org/0000-0002-8128-1128
  • Natalie Thöne Facultad de Medicina, Pontificia universidad católica de Chile
  • Josefina Duque Benavides Facultad de Medicina, Pontificia universidad católica de Chile
  • Rocío Brañes Fierro Facultad de Medicina, Pontificia universidad católica de Chile http://orcid.org/0000-0001-5508-0296

Palabras clave:

ear piercing, perichondritis, transcartilaginous ear perforations, pseudomonas infections.

Resumen

Background: transcartilaginous perforations have become a prominent practice among adolescents and young adults in recent years, which are associated with an increased risk of complications since it is frequently performed without sterile technique and by unqualified individuals. The transgression of the integrity of the skin and cartilage of the ear favors infections such as cellulitis, chondritis, perichondritis or abscesses that can cause serious deformities. Methods: we present a clinical case compatible with a perichondritis secondary to ear perforations with three abscesses.
Results: the three abscesses were drained with sterile technique and successfully managed with outpatient antibiotic treatment. In relation to the pathophysiology, the trauma in the auditory pavilion produces the extraction of the adjacent perichondrium, causing devascularization of the cartilage and microfractures, which together with the transgression of the skin, increase the susceptibility to infection. In addition, subpericardial bleeding and inflammatory reaction decrease the blood supply, which limits the immune response and the effectiveness of antibiotics. In some cases, incision and drainage are required. The signs of perichondritis include pain, swelling, and erythema of the skin. Clinically, perichondritis can be differentiated from cellulitis of the pinna, in that the first usually does not involve the earlobe. The fluctuating swelling leads us to an abscess. Conclusions: the administration of broad-spectrum antibiotics should be immediately administered and include coverage for Pseudomonas aeruginosa since it is responsible for the majority of post-perforation cartilage infections (up to 95% of cases). Due to the increase of post-perforation infectious complications, all physicians should be familiar with its diagnosis and treatment.

Biografía del autor/a

Javier Ignacio Rodríguez Gutiérrez, Facultad de Medicina, Pontificia universidad católica de Chile

Departamento de cirugía, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Departamento de educación médica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Médico Cirujano, Magíster en educación médica, Residente de Cirugía UC 

Natalie Thöne, Facultad de Medicina, Pontificia universidad católica de Chile

Departmento de otorrinolaringología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Departamento de educación médica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Médico Cirujano, Magíster en educación médica, Residente de Otorrinolaringología UC  

Josefina Duque Benavides, Facultad de Medicina, Pontificia universidad católica de Chile

Escuela de Medicina, Facultad de Medicina, Pontificia Universidad católica de Chile

Rocío Brañes Fierro, Facultad de Medicina, Pontificia universidad católica de Chile

Escuela de Medicina, Facultad de Medicina, Pontificia Universidad católica de Chile

Citas

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Publicado

2019-05-31

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Casos Clinicos

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