A challenging disease entity

A challenging disease entity

Parotitis is characterized by soreness and swelling of the parotid gland. Observing the mouth while massaging the gland may reveal obstructed flow or flow of purulent material from the aperture near the upper molars.

"Parotitis" is the medical name for a swollen parotid gland. The parotid glands are placed on the side of your face, between your ear and jaw. “Parotid gland enlargement is frequently related with mumps (also known as viral parotitis). However, parotitis can be the result of a variety of different disorders, including salivary gland stones, autoimmune diseases, dental issues, and viral and bacterial infections.The disorder could be acute (short-term) or chronic (long-term),” says Dr Sandeep Ghanta, Diabetology & Internal Medicine, Star Hospital.

Who does parotitis affect?
Parotitis can affect people of various ages, especially because parotid gland swelling is a symptom of many underlying illnesses, including the flu, HIV, staph infections and COVID-19. “Viral acute parotitis (mumps) is most frequent in children, but its prevalence has decreased with the development of the MMR vaccine. A person with parotitis experiences extreme swelling on one side of their face. In most cases, the swelling is bilateral. However, some persons experience an enlarged parotid gland on only one side (unilateral),” says Dr Sandeep Ghanta.

Symptoms
“Symptoms of a swollen parotid gland can vary depending on the underlying condition,” says Dr Sandeep. Some of the most common parotitis symptoms include: Pain where the gland is swollen, Fever, Chills, Headache, Sore throat, General malaise or tiredness, Loss of appetite.Most people with acute parotitis have extremely tender parotid glands. Those with chronic parotitis usually don’t have much pain or discomfort,” he says.

Causes
There are numerous reasons why a person's parotid gland may expand, and the risk factors are not always evident.Parotid gland swelling may be associated with:Mumps, Herpes, Epstein-Barr, Influenza, COVID-19, Staph infections, Candida or other fungal infections, Diabetes, Salivary gland inflammation (sialadenitis), Salivary gland stones (sialolithiasis), Salivary gland tumors,Poor oral hygiene,Dehydration,Sjogren’s syndrome,Sarcoidosis,Tuberculosis,Hiv ,Cystic fibrosis Certain drugs, like some antihistamines, antidepressants and antipsychotics.

What virus causes parotitis?
Many different viruses can induce swelling in the parotid glands. However, the most prevalent is MuV, the virus that causes mumps. Other viruses include herpes, HIV, Epstein-Barr, and COVID-19.

Is parotitis contagious?
Parotitis, which is caused by a viral or bacterial illness, is easily transmitted to others by saliva (spit) droplets. If you have contagious parotitis, avoid sharing personal objects like towels, eating utensils etc.

Diagnosis
A medical professional will visually inspect your face. They may lightly press on the skin around your ears and jawline.To confirm a parotitis diagnosis, your physician may massage your parotid gland from back to front. This allows them to evaluate whether discharge (pus) is present in your saliva.Next, they will do bacterial culture testing to determine the best course of action.If parotid gland irritation or stones are detected, a healthcare practitioner may recommend a CT or MRI scan of the parotids.

Treatment
When parotitis is caused by a viral, bacterial, or fungal infection, your doctor will prescribe the proper treatment (antivirals, antibiotics, or antifungals). Acetaminophen and ibuprofen are two over-the-counter pain medications that can assist alleviate tenderness and discomfort.Otherwise, parotitis treatment is heavily dependent on the underlying illness.When nonsurgical treatments do not work, a parotidectomy may be required. A parotidectomy is a procedure that removes all or part of the parotid gland. Surgery is often reserved for patients with parotid gland tumours or malignancy.

Prevention
The best way to prevent acute parotitis is to get the MMR vaccine.

Dr. Sandeep Ghanta MD (Internal Medicine), DIDM,

FICM Consultant,

Department of Internal Medicine.

StarHospital, Nanakramguda