Viral parotitis: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Prodrome of [[fever]], malaise, [[headache]], myalgias, [[arthralgias]] | *Prodrome of [[fever]], malaise, [[headache]], myalgias, [[arthralgias]] | ||
*Unilateral or bilateral parotid swelling | *Unilateral or [[bilateral parotitis|bilateral]] parotid swelling | ||
*Unilateral [[orchitis]] (20-30% of male patients) | *Unilateral [[orchitis]] (20-30% of male patients) | ||
| Line 21: | Line 21: | ||
*Generally a clinical diagnosis | *Generally a clinical diagnosis | ||
*May confirm diagnosis with mumps immunoglobulin (IgM and IgG) or PCR (may also be needed by local health department for reporting) | *May confirm diagnosis with mumps immunoglobulin (IgM and IgG) or PCR (may also be needed by local health department for reporting) | ||
*Testicular ultrasound if concern for orchitis | *[[Testicular ultrasound]] if concern for [[orchitis]] | ||
*Lumbar puncture if concern for associated meningitis/ | *[[Lumbar puncture if concern for associated [[meningitis]]/[[encephalitis]] | ||
==Management== | ==Management== | ||
Revision as of 23:07, 30 September 2019
Background
- Acute infection of the parotid glands
- Most often caused by paramyxoviruses (e.g. mumps), but should consider influenza[1]; less commonly by parainfluenza, coxsackie, echo, HIV
- Most common in children <15yrs
- Contagious for 9 days after onset of parotid swelling
Complications
- Mastitis, pancreatitis, aseptic meningitis, hearing loss, myocarditis, polyarthritis, hemolytic anemia
Clinical Features
- Prodrome of fever, malaise, headache, myalgias, arthralgias
- Unilateral or bilateral parotid swelling
- Unilateral orchitis (20-30% of male patients)
Differential Diagnosis
Bilateral Parotitis
- Viral infections
- Viral parotitis
- Parainfluenza
- Coxsackie virus
- influenza A
- Epstein-Barr virus
- Adenovirus
- HIV
- Cytomegalovirus
- Bacterial infections
- Noninfectious
- Salivary calculi
- Tumors
- Sarcoidosis
- Sjögren’s syndrome
- Thiazide diuretics
Facial Swelling
- Buccal space infections
- Dental problems
- Canine space infection
- Facial cellulitis
- Herpes zoster
- Masticator space infections
- Maxillofacial trauma
- Neoplasm
- Parapharyngeal space infection
- Salivary gland diagnoses
- Parotitis
- Ranula
- Sialoadenitis
- Sialolithiasis
- Superior vena cava syndrome
Evaluation
- Generally a clinical diagnosis
- May confirm diagnosis with mumps immunoglobulin (IgM and IgG) or PCR (may also be needed by local health department for reporting)
- Testicular ultrasound if concern for orchitis
- [[Lumbar puncture if concern for associated meningitis/encephalitis
Management
- Supportive care is the mainstay of treatment
Disposition
- Isolated parotitis or orchitis: manage as outpatient
- Systemic complications: admit
- Report to local health department (nationally reportable disease)
See Also
External Links
Video
{{#widget:YouTube|id=ilEowtWdqsI}}
References
- ↑ Rolfes, Melissa A, et al. “Influenza-Associated Parotitis During the 2014–2015 Influenza Season in the United States.” Clinical Infectious Diseases, vol. 67, no. 4, 2018, pp. 485–492., doi:10.1093/cid/ciy136.