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Ear hit. Developed infection cellulitis. On clindamycin. Bumps on cartilage that pain. Remove them?

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hello...4 weeks ago my left ear was hit by a car door...i developed infection cellulitis...so far i've been on 4 different antibiotics...the last one was clindamycin iv for 10 days...the infection is improving but very slowly...i also have two bumps on my cartilage which are painful, hard, and not improving...emerg doc said that ent specialist will have to remove them...what are they? is that dead cartilage?
Posted Sat, 5 May 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 6 hours later
Hi,
Thank you for your query.
There are a few issues that I would like to clarify here.
1. Cartilage has extremely poor blood supply as it grows very slowly. The only other tissue in the body with a lesser blood supply and growth rate is bone. Hence, antibiotics do not reach easily to the site of infection in cartilage and bone. Also, healing is slow as seen with fractures. Cartilage may heal with fibrosis or not heal at all.

2. Clindamycin achieves high levels in bones and body fluids such as synovial fluid and saliva. An infection may be due to resistant organisms and may thus not respond.

3. If the skin over the ear cartilage was broken, the chances of infection are higher. A closed wound is less likely to be infected.

4. The bumps are more likely to be tense collections of inflammatory fluid under the perichondrium ( the layer which covers the cartilage). They may be drained and a pressure bandage given to prevent re-accumulation. Any drained fluid should be sent for culture and antibiotic sensitivity.
5. Separation of the perichondrium on both sides of the cartilage may devitalize it. Dead cartilage need not be removed unless it is infected.
6. I would also like to know if you have been prescribed any anti-inflammatory medication?

I hope I have answered your query. If you have any further questions, I will be available to answer them.

Regards
Above answer was peer-reviewed by
 
Follow-up: Ear hit. Developed infection cellulitis. On clindamycin. Bumps on cartilage that pain. Remove them? 10 hours later
there was no visible skin break...all the antibiotics seemed to be working at first...the ear is better but still red and the bumps are painful and hot...none of the doctors ( i have seen 5 of them) recommended doing cultures...which i think should be done from the get go...thank you so much...i am seeing a specialist tomorrow...what should i ask for?
 
 
Answered by Dr. Sumit Bhatti 1 hour later
Hi,

Thank you for writing back.

1. Discuss with your specialist that you are expecting that a perichondritis or celulitis has developed.

2. Other conditions to be ruled out are a sub-perichondrial hematoma, seroma or a pseudocyst.

3. If there is pus, severe pain or fever, surgical drainage will be necessary. You may have to continue IV antibiotics. Steroids and anti-inflammatory medication may be added. A local antibiotic ointment may be used locally.

4. Prompt treatment will ensure full recovery and no deformity of the pinna (auricle / external ear).

I hope I have answered your query. If you have any further questions, I will be available to answer them.

Regards
Above answer was peer-reviewed by
 
Follow-up: Ear hit. Developed infection cellulitis. On clindamycin. Bumps on cartilage that pain. Remove them? 51 minutes later
i am afraid its too late now...it has been 4 weeks of this nonsense...i hope i wont end up with deformed ear...thank you so much doctor...your answers are right on...
 
 
Answered by Dr. Sumit Bhatti 1 hour later
Hi,

Thank you for writing back.

You should follow up with your specialist. You may also share the reports and, if possible, a close-up image of your left ear.

I sincerely hope that you have a good recovery.

Regards.

Above answer was peer-reviewed by
 
Follow-up: Ear hit. Developed infection cellulitis. On clindamycin. Bumps on cartilage that pain. Remove them? 23 hours later
hello
the specialist told me its an cartilage inflamation...put me on steroids and antibiotic cipro...ask me about polychodritis history in my family...no one have that...can cartilage become inflamed due to trauma???...how long it takes fot this to heal?...
 
 
Answered by Dr. Sumit Bhatti 27 minutes later
Hi,

Thank you for following up.

Perichondritis (inflammation of the perichondrium and cartilage) frequently occurs following trauma. Sometimes there is a lot of inflammatory fluid and exudate collection in the area of the injury which delays healing. As explained above, healing time is prolonged and may take between two to eight weeks with treatment. Is there any history of keloid (hypertrophic scar) formation with you or any one in your family? If so, then intra-lesional steroid injections may also help prevent scarring.

Wishing you a speedy recovery.

Regards.
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