What is the Diagnosis of Parotitis

By  ,  Onlymyhealth editorial team
Jul 13, 2011

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Quick Bites

  • The diagnosis of parotitis is clinical.
  • The infection is usually unilateral.
  • Bilateral infections are more associated with neonatal cases.
  • CT scan and MRI with gadolinium enhancement may be used.

Parotitis is inflammation of the parotid salivary gland: it can be acute, chronic, or chronic with acute exacerbations. Acute suppurative parotitis was a well recognized complication of abdominal surgeries prior to routine administration of perioperative antibiotics.

Your doctor will ask about your symptoms and medical history. A physical exam will be done. This may be enough to make a diagnosis. Tests may include a blood test and a fluid sample from the parotid gland.

Imaging tests evaluate the parotid gland and surrounding structures. These may include:

  • Ultrasound
  • CT scan
  • MRI scan
  • Sialography to evaluate the ducts in and around the parotid gland

Parotitis Diagnosis

The diagnosis is clinical. Acute parotitis presents with sudden onset of indurated, warm, erythematous swelling see photos of the pre- and post-auricular areas, with intense local pain and tenderness. Symptoms are often associated with high fevers, chills, and marked systemic toxicity. The infection is usually unilateral; bilateral infections are more associated with neonatal cases. Purulence from the gland see photos and Gram stain may support the diagnosis of acute suppurative parotitis. Cultures may be obtained from parotid needle aspiration.

Late in the course of the infection, massive swelling of the neck and respiratory obstruction may occur. Other late manifestations include septicaemia, osteomyelitis of adjacent bones, and organ failure.

Sialography in contraindicated in the acute stage of infection due to the risk of rupture of an ectatic duct from the pressure of injected dye and usually incites intense pain. Ultrasound is replacing sialography in the evaluation as it is easier to perform, demonstrates solid masses or fluid collections within the gland, and detects hypoechoic areas that correspond to punctate sialectasis by sialography. CT scanning and MRI with gadolinium enhancement may be used to determine the size, shape, and presence of a neoplasm or abscess within the gland.

Image: Getty

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