Perichondritis: Not All Ear Pain Is Otitis

Acute auricular perichondritis is an infection and inflammatory disease of the external ear that can potentially cause serious complications if not diagnosed and treated promptly. Delays in treatment can lead to devastating focal cartilage necrosis and, subsequently, permanent deformities of the ear. We present the case of a two-year-old boy who was diagnosed with acute perichondritis after presenting to the emergency department (ED) with acute ear redness, swelling, and tenderness. In this article, we will discuss how the diagnosis of perichondritis is made and give a brief literature review on the management approaches and the reasoning behind them. Particularly, we address the dilemma of whether fluoroquinolones use in pediatric patients is safe and warranted in this disease entity, based on the latest evidence.