Parotitis is an inflammation of one or both parotid glands, the major salivary glands located on either side of the face, in humans. The parotid gland is the salivary gland most commonly affected by inflammation. Etymology
From Greek παρωτῖτις (νόσος), parōtĩtis (nósos) : (disease of the) parotid gland < παρωτίς (stem παρωτιδ-) : (gland) behind the ear < παρά - pará : behind, and οὖς - ous (stem ὠτ-, ōt-) : ear. Causes
Dehydration
Dehydration:
This is a common, non-infectious cause of parotitis. It may occur in elderly or after surgery. Infectious parotitis
Acute bacterial parotitis:
is most often caused by a bacterial infection of Staphylococcus aureus but may be caused by any commensal bacteria. Parotitis presents as swelling at the angle of the jaw. Bacterial parotitis presents as a unilateral swelling, where the gland is swollen and tender and usually produces pus at the Stensens duct. This pus is usually sampled and the bacteria within are identified. Common causative bacteria are Staphylococcus aureus, Streptococcus pyogenes and E coli. It is associated with poor oral hygiene; oral infections and decreased saliva production. Symptoms include fever, dehydration, chills, fast heartbeat and breathing if the infection is causing sepsis. Medications such as antihistamines and diuretics can be predisposing factors. Treatment is usually antibiotics.Parotitis as extrapulmonary tuberculosis:
The mycobacterium that cause tuberculosis can also cause parotid infection. Parotid swelling can be an uncommon symptom of extrapulmonary tuberculosis (TB outside of the lungs). The usual symptoms are a cough, fever, weight loss, shortness of breath, chest pain, tiredness and chills.
The duct orifice normally functions as a valve to prevent air from entering the gland from a pressurized oral cavity. Rarely, an incompetent valve allows insufflation of air into the duct system. Pneumoparotitis most commonly occurs in wind instrument players, glass blowers, and scuba divers.Several lymph nodes reside within the parotid gland as a superficial and deep group of nodes. These nodes may be involved with any process that affects lymph nodes, including bacterial, fungal, viral, and neoplastic processes. Rarely, drugs such as iodides, phenylbutazone, thiouracil, isoproterenol, heavy metals, sulfisoxazole, and phenothiazines cause parotid swelling.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. Causes are not well understood. Ideal treatment should be preventative and can involve medication that increases saliva production (sialagogues), anti-inflammatory medication and the application of hot packs. Occasionally pilocarpine can be used to help resolve the swelling. Masseteric hypertrophy
Masseteric hypertrophy (enlargement of the masseter muscles volume) can present as facial swelling in the parotid gland area and may be confused with true parotid gland swelling. The specific cause of masseteric hypertrophy is still unclear, but it may be related to tooth grinding or malocclusion. Treatment options can include surgical removal of some of the muscle and botulinum toxin type A injections. Diagnosis
Serum and urinary amylase rise during the first week of parotitis. Treatment
Treatment is based on lab investigation report. Notes
References
Brook I. Acute bacterial suppurative parotitis: microbiology and management.