Viral parotitis: Difference between revisions
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==Background== | ==Background== | ||
[[File:Gray1024.png|thumb|Parotid anatomy.]] | |||
*Acute infection of the parotid glands | *Acute infection of the parotid glands | ||
*Most often caused by paramyxoviruses (e.g. [[mumps]]), but should consider [[influenza]]<ref>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.</ref>; less commonly by parainfluenza, [[coxsackie]], echo, [[HIV]] | *Most often caused by paramyxoviruses (e.g. [[mumps]]), but should consider [[influenza]]<ref>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.</ref>; less commonly by parainfluenza, [[coxsackie]], echo, [[HIV]] | ||
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==Clinical Features== | ==Clinical Features== | ||
[[File:PMC3385293 aps-39-59-g001.png|thumb|Right sided parotitis with parotid swelling.]] | |||
*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) | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Bilateral parotitis DDX}} | {{Bilateral parotitis DDX}} | ||
{{Facial swelling DDX}} | {{Facial swelling DDX}} | ||
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*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== | ||
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==External Links== | ==External Links== | ||
*[https://www.cdc.gov/mumps/hcp.html CDC: Mumps for HCP] | *[https://www.cdc.gov/mumps/hcp.html CDC: Mumps for HCP] | ||
*[https://www.merckmanuals.com/professional/pediatrics/miscellaneous-viral-infections-in-infants-and-children/mumps#:~:text=(Epidemic%20Parotitis)&text=Mumps%20is%20an%20acute%2C%20contagious,orchitis%2C%20meningoencephalitis%2C%20and%20pancreatitis. Merck Manual: Mumps] | |||
==References== | ==References== | ||
Latest revision as of 15:44, 10 April 2024
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
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.