Auricular Perichondritis of an Unusual Etiology
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Auricular Perichondritis of an Unusual Etiology Sujatha Sistla1 • Devi Prasad Mohapatra2 • Radha Sugumaran1 • Saurabh Gupta2 Friji Meethale Thiruvoth2 • Likhitha Reddy2
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Received: 3 July 2020 / Accepted: 18 August 2020 Ó Association of Otolaryngologists of India 2020
Abstract Auricular perichondritis leading to perichondral abscess is an unusual complication of periauricular surgery. Early identification of the condition with aggressive and timely management is mandated to prevent permanent damage to the auricle. This article demonstrates the first reported case in literature of auricular perichondritis due to Neisseria flava. We discuss the presentation, diagnosis and management of auricular perichondritis in this patient and review mechanisms by which commensals acquire pathogenicity as seen in this report. An awareness of this unusual etiology and mechanisms of acquiring pathogenic nature by commensals will help guide clinicians in optimizing management of such conditions. Keywords Perichondritis Perichondrial abscess Neisseria soft tissue infections Preauricular basal cell carcinoma
Introduction Auricular perichondritis leading to perichondral abscess is and unusual complication of periauricular surgery. Early identification of the condition with aggressive and timely management is mandated to prevent permanent damage to
& Devi Prasad Mohapatra [email protected] 1
2
Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India Department of Plastic Surgery, Superspeciality Block, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India
the auricle. We present below a report of an auricular perichondritis due to a unusual etiology, its diagnosis and management.
Case Presentation Our patient a 50-year-old female with no co-morbidities, presented with 3 cm 9 4 cm slow-growing, darkly pigmented lesion of the right preauricular area with central ulceration of nearly 8 months duration (Fig. 1a). The lesion was clinically diagnosed to be a pigmented basal cell carcinoma and the patient was subjected to surgery. Her preoperative screening blood tests were within normal limits. Excision of the lesion was carried with a standard 5 mm margin and the specimen sent for histopathological study which confirmed the diagnosis of pigmented Basal cell carcinoma with margins free of tumor. The defect was resurfaced with a cervicofacial advancement flap which healed well. Removal of sutures was done at 7 days. Ten days following suture removal the patient presented in our OPD with pain and swelling over the right pinna of two days duration. On examination, an erythematous, fluctuant, tender, swelling was noted on the ventral aspect of pinna overlying the concha (Fig. 1b). The patient was admitted with a diagnosis of perichondritis and perichondral abscess of the right pinna and broad-spectrum antibiotics were started.
Laboratory Investigation Needle aspirated pus from absc
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