Hospital-based incidence and clinical profile of pinna perichondritis at a tertiary referral center in Nepal: a retrospective study

Abstract Background Pinna perichondritis is a potentially deforming auricular infection that poses treatment challenges in low-resource settings, particularly where auricular trauma and trans-cartilaginous piercing are common. The aim of this study was to establish clinico-epidemiological data on pinna perichondritis, including its hospital-based incidence, clinical characteristics, treatment, and outcomes in patients presenting to a tertiary-level referral hospital in Nepal. Methods This was a retrospective observational study conducted by reviewing charts of 55 patients admitted with confirmed pinna perichondritis between May 2016 and May 2020 where those with incomplete records were excluded. Exposures assessed included auricular trauma, piercing, otologic surgery, allergic skin reactions, or community-level antibiotic use. Hospital management included intravenous antibiotics, surgical intervention when indicated, and supportive therapies. Main outcome measures were clinical presentation, predisposing factors, type and duration of antibiotic therapy, need for surgery, length of hospital stay, and outcomes including residual pinna deformity at discharge. Results Mean age was 32.6 ± 19.6 years; 63.6% were female. Unilateral involvement occurred in 98.2% of patients. Pain, redness, and swelling were most common (54.5%). Auricular trauma, including trans-cartilaginous piercing, was the leading predisposing factor (38.2%). Community antibiotic use was documented in 43.6%, mainly penicillin (45.8%) and fluoroquinolones (41.7%). All patients received intravenous antibiotics, most frequently fluoroquinolones (47.3%), for 5 ± 11.6 days (median = 5). Surgery was required in 34.5%. Hospital-based incidence was 5.07 per 1,000 admissions. At discharge, 96.4% improved; 12.7% had residual deformity. Conclusion Pinna perichondritis in Nepal is predominantly associated with auricular trauma and piercing. Intravenous antibiotics, particularly fluoroquinolones, are the mainstay, with surgery required in selected cases. Residual deformity remains a concern and therefore, early recognition, timely referral, and standardized treatment protocols are essential. This is the first study to report hospital-based incidence of pinna perichondritis, providing a benchmark for future studies and preventive strategies in similar healthcare settings.