Viral parotitis

Background

• Acute infection of the parotid glands
• Most often caused by paramyxoviruses (e.g. mumps); less commonly by influenza, 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
  • Staphylococcus aureus
• 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
    • Bilateral parotitis
    • Suppurative parotitis
    • Viral parotitis (Mumps)
  • Ranula
  • Sialoadenitis
  • Sialolithiasis
• Superior vena cava syndrome

Management

• Supportive

Disposition

• Isolated parotitis or orchitis: manage as outpatient
• Systemic complications: admit

See Also

• Salivary Gland Infections
• Bilateral parotitis

Video

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