Question

A 16-year-old high school wrestler presents after an injury during a match which has resulted in a fluctuant, mildly tender edematous lesion of the anterior-superior outer portion of the right pinna. Which of the following is the most appropriate treatment?

A. Refer to otolaryngology for definitive treatment with I & D and pressure dressing
B. Perform I & D only if the pinna becomes erythematous and extremely tender
C. Prescribe a 10-day course of amoxicillin/clavulanate (Augmentin) and schedule a follow-up appointment in 2 weeks
D. Apply a soft bulky dressing to the pinna and recommend no further treatment, but have the patient follow-up only if he develops a temperature greater than 101 degrees

Answer 1

The appropriate treatment for the injured wrestler is to refer to an otolaryngologist for incision and drainage (I&D) and pressure dressing, rather than antibiotics or simple dressings.

Step-by-step explanation:

The most appropriate treatment for a 16-year-old high school wrestler presenting with a fluctuant, mildly tender edematous lesion of the anterior-superior outer portion of the right pinna after an injury is to refer to an otolaryngologist for definitive treatment. This treatment would likely involve an incision and drainage (I & D) of the lesion, with a subsequent pressure dressing to ensure proper healing and to prevent additional infection or complications such as 'cauliflower ear.'

Antibiotics are generally not the first line of treatment for such injuries unless there is evidence of bacterial infection, which may manifest as erythematous and extremely tender tissue, purulence, or systemic symptoms like fever. Applying a soft bulky dressing without further action or prescribing antibiotics without indication of infection are not likely to be sufficient treatments for this type of injury.