Pediatria pre prax 1/2026
Risk of ear piercing
Objective: To describe a clinical case of perichondritis with abscess formation after cartilage ear piercing and to emphasize the importance of early and appropriate therapy to prevent permanent cartilage damage.
Case report: An 18-year-old female who underwent ear concha piercing one month earlier presented acutely to the ORL office with five days of pain, swelling and erythema of the pinna around the piercing site. Initial outpatient treatment included removal of the earring, topical betamethasone/gentamicin and oral amoxicillin/clavulanate. Despite this therapy, fluctuance and purulent discharge developed and on day five the patient was admitted to our ENT clinic. We administered intravenous antibiotic ciprofloxacin and performed incision and drainage of subperichondrial and retroauricular abscesses under general anesthesia. Pressure dressing was applied to the auricle. Culture from the swab showed Pseudomonas aeruginosa sensitive to ciprofloxacin and gentamicin. The pressure dressing was changed daily for 7 days and antibiotic therapy continued for 14 days postoperatively. The cartilage was preserved and the auricle retained a normal contour.
Discussion: Cartilage ear piercings are increasingly popular, especially among adolescents and young adults. Piercings are often performed under substerile conditions with poor aftercare information, which can lead to perichondritis and auricular abscess. Prevention includes strict adherence to sterile technique, use of sterilizable or single‑use instruments and appropriate antiseptics. At the first sign of infection, specialist care should be sought promptly. Empiric antibiotic therapy should target Pseudomonas aeruginosa, which is the pathogen in approximately 95 % of perichondritis cases. Fluoroquinolones are first‑line drugs because of good activity and ear tissue penetration. When an abscess has formed, timely incision, drainage and pressure dressing are essential to protect the cartilage.
Conclusion: Education of clients, piercing‑parlor staff and physicians, adherence to sterile procedures and early specialist referral are key to protecting cartilage and preventing permanent deformity.
Keywords: ear piercing, auricular perichondritis, perichondral abscess, Pseudomonas aeruginosa
