Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
147 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

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

Answered by
Dr.
Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2589 Questions

default
Posted on Fri, 29 Jun 2012 in Ear, Nose and Throat Problems
Question: 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?
doctor
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 : Dr. Aparna Kohli
doctor
default
Follow up: Dr. Sumit Bhatti 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?
doctor
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 : Dr. Yogesh D
doctor
default
Follow up: Dr. Sumit Bhatti 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...
doctor
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 : Dr. Raju A.T
doctor
default
Follow up: Dr. Sumit Bhatti 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?...
doctor
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.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,  
Medical Topics ,   ,  

Recent questions on  Deformity

doctor1 MD

Hello, I am a 22 year old female and don t have any medical conditions. I am worried that I might have rectal prolapse or haemorrhoids, but I am...

doctor1 MD

Hi, I'm 14, and my spine sticks out even if I'm not bending over, I'm 120 pounds, 5'4 1/2, not super skinny or anything, could something cause...

doctor1 MD

My wife, age 83, has developed a situation where her dominant hand (left) the index and ring fingers have curled into the palm and those knuckles...

doctor1 MD

i just wrote to Dr. XXXXXXX Rynne but he never answered me back. I am not allowed to take any over the counter anti inflammatory pills. I have a...

doctor1 MD

CT Scan of Paranasal sinuses says " Large polypoid soft tissue is seen in the left maxillary sinus along its floor. Mild mucosal thickening is seen...

doctor1 MD

I am experiencing a tingling sensation on the right upper side of my stomach. It's only when I am putting any type of pressure on it, like sitting...

doctor1 MD

I feel lightheaded in the morning, usually after standing from sitting or bending over. I've had this off and on in my adulthood (age 42) but the...