Late-onset Pseudomonas aeruginosa Infection Following Revision Otoplasty

Suture-based otoplasty is a reliable aesthetic procedure with low complication rates. While early postoperative infections are documented, delayed infections involving the auricular cartilage—particularly those caused by Pseudomonas aeruginosa —are rare but clinically significant, nonetheless. A healthy 20-year-old female underwent a minor right-sided revision otoplasty, one year after primary bilateral otoplasty. Two months post-revision, she developed painful retroauricular swelling resistant to antibiotics. Surgical drainage was performed, and cultures confirmed P. aeruginosa . The infection resolved completely within 15 days of drainage and targeted therapy. Meticulous management ensured the preservation of the aesthetic result with no evidence of cartilage necrosis or permanent auricular deformity. This case highlights that late-onset infections can emerge despite standard fascial flap coverage of non-absorbable sutures. Successful management relies on early surgical intervention and prolonged, culture-specific antibiotic therapy. To mitigate risk, we have implemented reinforced peri-operative disinfection protocols. Early recognition is vital to preventing irreversible chondritis and maintaining surgical outcomes.