Suppurative parotitis

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Background

  • Serious bacterial infection of parotid gland that occurs in patients with decreased salivary flow
    • Caused by retrograde migration of oral bacteria into salivary ducts and parenchyma
    • Usually caused by staph, strep, anerobes

Risk factors

  • Dehydration
  • Prematurity or advanced age
  • Sialolithiasis
  • Oral neoplasms
  • Salivary duct strictures
  • Meds (cause systemic dehydration or decrease salivary flow)
  • Chronic illnesses

Clinical Features

  • Rapid onset
  • Skin over parotid gland is red and tender
  • Purulent drainage from Stensen's duct
  • Fever
  • Trismus

Differential Diagnosis

Facial Swelling

Evaluation

  • Usually clinical

Management

Supportive Care

  1. Hydrate the volume-depleted patient
  2. Massage and apply heat to the affected gland
  3. Stimulate salivation using sialagogues such as lemon drops

Antibiotic Options

Treatment targeted at S. aureus, gram negative bacilli, mumps, enteroviruses, and influenza virus

See Also

References