Red Puffy Ears

A 63-year-old man with a history of recurrent aseptic meningitis presented with fever and headache. The physical examination showed scleral injection and mild nuchal rigidity. Analysis of the cerebrospinal fluid revealed a mild monocytic pleocytosis indicative of aseptic meningitis. Despite supportive care, the patient had persistent fevers, anorexia, and headache. During treatment, marked bilateral auricular swelling and redness developed (Panel A). Auricular biopsy showed inflammatory changes that are seen in relapsing polychondritis. The administration of a corticosteroid improved the meningeal symptoms and reduced the auricular swelling (Panel B) within a few days. Relapsing polychondritis is a rare rheumatologic disorder that . . .