Improving the management of pinna abscess – A case series

Introduction If auricular perichondritis is left untreated or sub optimally managed the development of a subperiosteal abscess with potential cartilage loss and gross cosmetic defect may ensue. Materials and Methods A retrospective review was conducted to identify the cause, microbiology, management and outcome of patients presenting with pinna abscess over a 5-year period at a tertiary hospital. Results All 17 patients underwent incision and drainage of their abscess at least once. 14 patients had microbiology samples; 10 culture-positive. The commonest pathogen was Pseudomonas aeruginosa (5). A range of initial empirical therapy was used; appropriately in only one case. 8 patients developed complications. Discussion and Recommendations Pseudomonas aeruginosa is associated with pinna abscesses, particularly caused by high piercings. Suboptimal antimicrobial management was associated with poor outcomes. We recommend clinicians review their empirical treatment of pinna abscesses and have systems to act on microbiology results. Clinicians must consider Pseudomonas aeruginosa when managing resistant cases of abscesses or due to high piercings.