Recurrent tragal abscess associated with frequent in-ear headphone use: a case report

Localized infections of the auricle and tragus are uncommon. Recurrent disease should lead clinicians to ask about possible risk factors and contributing factors. A 39-year-old medically and surgically free man presented with a 3-day history of painful right tragal swelling preceded by localized discharge. He denied fever and trauma. He had two earlier similar episodes affecting both ears at different times, both resolving spontaneously. He reported frequent prolonged use of in-ear headphones, with symptoms usually following heavy in-ear headphone use. Incision and drainage were done, and pus culture grew Staphylococcus aureus. Initial clindamycin dosing was incorrect, so treatment was subtherapeutic. He was then switched to trimethoprim-sulfamethoxazole along with topical mupirocin with clear improvement. At follow-up, pain and discharge had resolved and the swelling was smaller. This case suggests that prolonged in-ear headphone use may be a contributing factor in recurrent tragal abscess.