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2.1
Parotitis
Parotitides

Images

WIKIDATA, Public Domain

Presentation

A case is presented of a 14-year-old female undergoing orthodontic fixed appliance treatment who presented with right facial swelling in the parotid region. An initial diagnosis of acute infective parotitis was made by her primary care clinician. [ncbi.nlm.nih.gov]

Entire Body System

  • Swelling

    Sialodochitis fibrinosa and allergic parotitis have described rare patients with recurrent salivary gland swelling and mucus plugs, often with atopy. [ncbi.nlm.nih.gov]

    ‘true’ parotid gland swelling. [en.wikipedia.org]

  • Pain

    Chronic recurrent non-specific parotitis is characterized by recurrent episodes of swelling and pain of unknown etiology in the parotid gland. [ncbi.nlm.nih.gov]

    Juvenile recurrent parotitis (JRP) is an inflammatory disease characterized by recurrent painful swelling of the Parotid gland in the pediatric age. [clinicaltrials.gov]

    Occasionally, however, the radiologist is asked to examine them (usually in the setting of pain or swelling). In children, the main cause for painful enlargement of the parotid is an entity called viral parotitis, usually caused by Mumps. [radiopaedia.org]

  • Inflammation

    Retrieved from https://www.yourdictionary.com/parotitis parotitis also pa·rot·i·di·tis noun Inflammation of the parotid glands, as in mumps. [yourdictionary.com]

    From Wikidata Jump to navigation Jump to search parotid disease characterized by the inflammation of one or both parotid glands parotid glanditis parotid gland inflammation edit English parotitis parotid disease characterized by the inflammation of one [wikidata.org]

    Two different patterns were identified by MRI: acute inflammation versus chronic inflammation. Contrast enhancement of the parotid gland indicated acute inflammation. [jiaps.com]

    A differential diagnosis has to rule out inflammation of the cervical lymph nodes, Caffey Silverman Disease, inflammation of soft tissues due to erysipelas or infection due to H. [czytelniamedyczna.pl]

    Recurrent parotitis is an acute, severe inflammation of one or both parotid glands, the major salivary glands in young children. [ncbi.nlm.nih.gov]

  • Fever

    A 10-year-old boy presented with persistent fever and parotitis and was diagnosed with suppurative parotitis. [ncbi.nlm.nih.gov]

    The most characteristic symptoms include swelling of he parotid glands, erythema, pain, fever and poor suckling. [czytelniamedyczna.pl]

    The children may present with viral symptoms like fever, dry cough, and body pain, but a dominant feature may be the viral parotitis, which appears on US as heterogenicity of the parenchyma with hyperemia. [radiopaedia.org]

Gastrointestinal

  • Vomiting

    Treatment Complications Orchitis ( < 10% of cases; most c ommon complication in post-pubertal males ) Primarily unilateral, although bilateral in ∼ 15% of cases Sudden onset of fever, nausea, vomiting On examination: swollen and tender affected testicle [amboss.com]

    Pancreatitis, typically with sudden severe nausea, vomiting, and epigastric pain, may occur toward the end of the first week. These symptoms disappear in about 1 week, leading to complete recovery. [msdmanuals.com]

    Associated with Bulimia : Parotid gland swelling is a common feature of self-induced vomiting. This swelling usually develops 3–4 days after the stopping of chronic excessive self-induced vomiting. The swelling is bilateral, with little tenderness. [en.wikipedia.org]

    Symptoms of mumps meningitis include high fever, headache, neck stiffness, vomiting, and lethargy. Symptoms typically progress over 48 hours and resolve over a period of a week. [cancertherapyadvisor.com]

  • Nausea

    Treatment Complications Orchitis ( < 10% of cases; most c ommon complication in post-pubertal males ) Primarily unilateral, although bilateral in ∼ 15% of cases Sudden onset of fever, nausea, vomiting On examination: swollen and tender affected testicle [amboss.com]

    Pancreatitis, typically with sudden severe nausea, vomiting, and epigastric pain, may occur toward the end of the first week. These symptoms disappear in about 1 week, leading to complete recovery. [msdmanuals.com]

Jaw & Teeth

  • Dental Caries

    Can be associated with poor dental hygiene, dental caries and dehydration. The most common cause is Staph aureus (could be meticillin resistant Staph aureus - MRSA). Parotid gland is acutely tender, swollen with inflammation of the soft tissues. [gloshospitals.nhs.uk]

    Actinomyces in patients with a history of trauma or dental caries Acute, recurrent parotitis JRP may be secondary to chronic inflammation; etiology is unknown, but a genetic predisposition may exist. [unboundmedicine.com]

    Associated with dental infections Prevotella sp. Associated with dental infections Fusobacterium sp. Associated with dental infections Bacteroides sp. Actinomyces Associated with dental caries Rare Atypical mycobacteria Salmonella sp. [antimicrobe.org]

  • Periodontitis

    […] diseases Acute necrotizing ulcerative gingivitis Pericoronitis Peri-implantitis Periodontal abscess Periodontal trauma Periodontitis Aggressive As a manifestation of systemic disease Chronic Perio-endo lesion Teething Periapical, mandibular and maxillary [en.wikipedia.org]

Skin

  • Urticaria

    When they do occur, they usually manifest as a rash or urticaria. Our review of the recent literature found that while sialadenitis is listed as a possible side effect of sulfonamide use, no actual case has ever been reported until now. [ncbi.nlm.nih.gov]

Psychiatrical

  • Fear

    They feared the consequences of the unsightly scar and facial paralysis. Parotid abscess is depicted in the image below. Elderly man with parotid abscess. [emedicine.medscape.com]

Workup

Workup showed bilateral suppurative parotitis. Abscess developed despite antibiotic therapy requiring surgical drainage before final recovery. [ncbi.nlm.nih.gov]

We also propose a protocol for the diagnostic workup of JRP based on our findings and a review of the current literature. [analesdepediatria.org]

Laboratory tests and autoimmune workup were completed in 7 patients. [jamanetwork.com]

Sialography was commonly used in the workup of parotid disease in the past, and this group demonstrates punctate sialectasis, which implies point like dilatations within the gland. Six-year-old girl with recurrent parotitis of childhood. [emedicine.medscape.com]

Treatment

Although symptomatic treatment with antibiotics and analgesic, injection of intraductal medicament, aggressive treatment like duct ligation or excision of gland are some of the treatment modalities, there is no established algorithm as to which treatment [ncbi.nlm.nih.gov]

In addition to the conservative follow-up treatment modality, management with operative endoscopic treatment is another considerable option, that is now gaining stronger evidence of efficacy. [clinicaltrials.gov]

Acute parotitis in neonates This rare form of parotitis is lethal without treatment. [emedicine.medscape.com]

Prognosis

Advances in antimicrobial therapy have improved both outcome and prognosis. Thanks to the prompt antibiotic treatment complications are now drastically reduced. Ultrasound examination may help in the diagnosis and monitoring of clinical course. [ncbi.nlm.nih.gov]

The prognosis is favorable with rare recurrence. The authors describe a case of an 8-day-old, full-term boy diagnosed with acute parotitis. [ejo.eg.net]

The prognosis in uncomplicated cases is very good. [amboss.com]

Prognosis In the long term, most cases of parotitis go away and don't return. Parotitis that is linked to another medical condition (such as HIV/AIDS or Sjögren's syndrome) may not go away completely. [colgate.com]

Etiology

Computational fluid dynamics analysis of salivary flow in the ductal system would be useful in future etiologic studies on parotitis. [ncbi.nlm.nih.gov]

We also tried to rule out infectious etiology by doing blood counts and autoimmune etiology by ESR, RA factor and ANA. The results were non-contributory. [jiaps.com]

The theories of etiology are diverse. Many authors are convinced that sialoliths or scarring of the ducts cause stasis of salivary flow and predispose the gland to infection is the etiology, but this is probably true for only a minority of cases. [emedicine.medscape.com]

Epidemiology

AIM: To characterize the features of juvenile parotitis in a prospective setup and epidemiology. METHODS: All children with parotitis admitted to Helsinki University Central Hospital 2005-2010 were recruited. [ncbi.nlm.nih.gov]

In the context of a mumps outbreak If the patient has acute parotitis and is suspected of having mumps infection because s/he is epidemiologically linked to an ongoing outbreak, testing for mumps infection is a priority as the parotitis is most likely [cdc.gov]

Pathophysiology

References: [3] [5] Pathophysiology Clinical features Incubation period : 16–18 days Asymptomatic course in ∼ 20% of cases Nonspecific or predominantly respiratory symptoms in ∼ 50% of cases Prodrome : Duration: 3–4 days Low-grade fever, malaise, headache [amboss.com]

Etiology and Pathophysiology Acute viral parotitis begins as a systemic infection that localizes to the parotid gland, resulting in inflammation and swelling of the gland. [unboundmedicine.com]

This might suggest a pathophysiological reason as to why the presence of an APG correlates to the pathogenesis of parotitis. Abnormal morphology of the salivary duct can interfere with the flow of saliva. [journals.plos.org]

Because the pathophysiology is poorly understood, the rationale of several surgical treatments is rather weak. Parotidectomy removes the diseased gland but begs the question of specific treatment. [emedicine.medscape.com]

Prevention

Once diagnosed as WG, appropriate therapy is able to prevent progression to severe clinical courses. [ncbi.nlm.nih.gov]

Antibiotic treatment prevents additional damage to the glandular parenchyma. [jisppd.com]

The spectrum varies from mild and infrequent attacks to episodes so frequent that they prevent regular school attendance. [en.wikipedia.org]

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