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    The document discusses acute parotitis, which is inflammation of the parotid salivary gland. The parotid gland secretes saliva through Stensen's duct. Acute parotitis can be caused by bacterial infection, most commonly Staphylococcus aureus, or viral infection like mumps. Risk factors include dehydration, malnutrition, immunosuppression, and medications that decrease salivation. Patients experience pain and swelling of the gland. Management involves antibiotic therapy for bacterial causes or surgical drainage if abscess forms.

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    The document discusses acute parotitis, which is inflammation of the parotid salivary gland. The parotid gland secretes saliva through Stensen's duct. Acute parotitis can be caused by bacterial infection, most commonly Staphylococcus aureus, or viral infection like mumps. Risk factors include dehydration, malnutrition, immunosuppression, and medications that decrease salivation. Patients experience pain and swelling of the gland. Management involves antibiotic therapy for bacterial causes or surgical drainage if abscess forms.

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    74 views3 pages

    Acute Parotitis

    Uploaded by

    noneoneone
    The document discusses acute parotitis, which is inflammation of the parotid salivary gland. The parotid gland secretes saliva through Stensen's duct. Acute parotitis can be caused by bacterial infection, most commonly Staphylococcus aureus, or viral infection like mumps. Risk factors include dehydration, malnutrition, immunosuppression, and medications that decrease salivation. Patients experience pain and swelling of the gland. Management involves antibiotic therapy for bacterial causes or surgical drainage if abscess forms.

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    of 3

    Acute Parotitis:

    Parotid gland - salivary gland enclosed within the fascial capsule.


    Comprises a superficial lobe and a deep lobe separated by facial nerve
    Exocrine gland secreting saliva after parasympathetic stimulation
    Stensen's canal is the primary excretory :

    passing through the masseter, penetrating the buccinator and into the oral mucosa lateral to second
    maxillary molar

    Saliva aids in chewing, swallowing, digestion and phonation

    Parotitis is the inflammation of the parotid gland


    Most common site of inflammation
    Can be a local process or a manifestation of systemic illness

    Predisposing factors:
    1. dehydration
    2. malnutrition
    3. immunosuppression
    4. sialolithiasis
    5. oral neoplasms
    6. medications causing decreased salivation

    rare complications:

    1. osteomyelitis
    2. Lemierre syndrome
    3. organ failure, facial paralysis

    Etiology:

    1. Parotitis: due to inflammatory conditions


    2. Acute bacterial is uncommon but occurs in extremes of age, occurring in elderly after Abdominal
    surgery, immunosuppression,
    3. dental infections increase the risk of acute bacterial parotitis
    4. Most common : staph aureus
    5. Other bacterial causes: Strep viridian's, E coli, anaerobic oral flora
    6. GBS

    Viral infections: Mumps/Paramyxovirus - epidemic parotitis


    Inflammatory conditions: sarcoidosis, Sjogren syndrome, rheumatoid arthritis, SLE
    Uncommon causes: include trauma, surgery, drug exposure

    Pathophsyiology:
    Presence of a ductal valve creates unidirectional flow of saliva out of the gland
    This prevents bacteria from entering
    However, at times it can become incompetent and result in ascending bacterial infection

    Dehydration or drying medications:


    1. Atrioine
    2. Antihistamines

    Can increase the risk of parotitis

    Sialolithiasis is common - calculi from inorganic crystals can obstruct the duct
    Bacteria trapped behind a high grade obstruction can proliferate and result in acute suppurative parotitis

    Hospital setting: MRSA, candida should be considered

    Autoimmune parotiis:
    Antigen antibody complex is endocytose into epithelial cells
    process into a HLA and recognized by CD4 T lymphocytes
    Augmenting more CD4 activation

    B lymphocytes enter acini and produce antibodies


    Autoimmune causes result in chronic parotitis

    HIV - symptomatic firm parotid swelling

    History and physical:

    Progressive enlargement,
    Pain in one or both glands
    Bilateral : for mumps and inflammatory condition
    Unilateral - bacterial cause
    Complain of pain with mastication and radiating to the ear

    Enlarged, edematous, tender


    Warm and indurated

    Parotid gently massaged from posterior to anterior - bacterial will exhibit purulent drainage from the duct
    Yellow crystal chunks - autoimmune parotitis
    Sialolithiasis - swelling around sorensen duct with a visible/palpable stone

    Management:

    1. Antibiotic therapy - for dealing with S. aureus based infection


    2. Surgical :

    a. If becomes purulent, can take a wire bore needle and aspirate or choose general drainage
    b. If I&D:
    i. Incision should be made low
    ii. Avoid facial nerve
    iii. Blunt dissection with sinus forceps

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