Parotitis Causes Symptoms, and Treatment

Parotitis is an inflammation of one or both parotid glands, which are large salivary glands responsible for producing about 50% of your saliva. The parotid glands are located in each cheek over the jaw and in front of the ears. Saliva plays a crucial role in health, containing electrolytes that support various bodily functions and enzymes like salivary amylase that help break down carbohydrates.

Types of Parotitis

Parotitis can affect all genders equally, but some types, such as acute bacterial parotitis, are more common in older populations.

Acute Bacterial Parotitis

Acute bacterial parotitis is caused by a bacterial infection, most commonly by Staphylococcus aureus. This type is rare among the general population and primarily affects older individuals, although it can also occur in infants and younger people.

Chronic Bacterial Parotitis

Chronic bacterial parotitis may result from stones (calculi) in the salivary glands, injuries causing duct narrowing, or decreased salivary flow leading to inflammation and infection.

Acute Viral Parotitis

Acute viral parotitis typically stems from viral infections, most commonly mumps, a contagious paramyxovirus that causes swelling of the salivary glands and a tender, swollen jaw. Other viral causes include influenza and enteroviruses such as Coxsackie A and echovirus.

Chronic Parotitis (Autoimmune)

Chronic parotitis, also known as autoimmune parotitis, is associated with chronic diseases like rheumatoid arthritis, Sjögren’s syndrome, and systemic lupus erythematosus. This type is characterized by recurring infections and symptoms.

Symptoms of Parotitis

The primary symptom of parotitis is swelling of the parotid glands. Other symptoms include:

• Sore throat
• Fever
• Cloudy-appearing saliva
• Unpleasant or abnormal tastes in the mouth
• Redness over the upper neck or side of the face
• Chronic, non-tender swelling (in certain conditions)
• Lump in the gland (in tuberculosis-related cases)
• Increasingly painful swelling, often aggravated by chewing (in acute bacterial parotitis)
• Lack of appetite, general discomfort, and fever (in acute viral parotitis)

Causes of Parotitis

Several factors can lead to parotitis, including:

• Bacterial infections (e.g., staphylococcus aureus, viridans streptococci, E. coli)
• Viral infections (e.g., HIV, influenza, enteroviruses)
• Mumps
• Decreased salivary flow
• Salivary gland blockage from stones
• Injuries causing duct narrowing
• Salivary gland tumors (benign or malignant)
• Metabolic disorders (e.g., diabetes)
• Inflammatory diseases (e.g., rheumatoid arthritis, Sjögren’s syndrome, sarcoidosis)
• Tuberculosis
• Certain medications (e.g., iodines or propylthiouracil for Graves’ disease and hyperthyroidism)

Risk Factors

Risk factors for acute bacterial parotitis include dehydration, malnutrition, dental infections, and cystic fibrosis. Older individuals, particularly those who have undergone abdominal surgery or use medications that reduce salivary flow, are at higher risk.

Diagnosis

To diagnose parotitis, a healthcare provider will discuss your symptoms and perform a physical examination to check for enlarged glands and pus or drainage in the mouth. Diagnostic tests may include:

• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI) scan
• Ultrasound
• Sialendoscopy (using a tiny camera to diagnose and treat salivary gland infections)

If pus or drainage is present, a sample may be sent for analysis to confirm a bacterial infection.

Treatments for Parotitis

Treatment aims to eliminate bacteria, reduce swelling and pain, expedite healing, and prevent complications. For milder cases, recommendations may include:

• Drinking plenty of water
• Applying warm compresses
• Gentle glandular massage
• Sialagogues (substances like lemons or sour candies that promote saliva production)
• Over-the-counter pain relief (e.g., acetaminophen, ibuprofen)

Acute bacterial parotitis typically requires antistaphylococcal antibiotics, possibly supplemented with gentamicin, analgesics, or intravenous (IV) hydration. Staying hydrated is crucial during treatment.

For parotitis caused by underlying conditions like tuberculosis or autoimmune diseases, managing the primary condition is essential for symptom relief.

Prevention

While parotitis cannot be completely prevented, you can reduce your risk by:

• Staying hydrated
• Avoiding smoking
• Maintaining good oral hygiene (brushing and flossing at least twice daily)

Related Complications

Untreated parotitis can lead to complications such as:

• Chronic bacterial parotitis
• Xerostomia (chronic dry mouth)
• Facial paralysis or nerve injury (rarely, from chronic inflammation or surgery/biopsies)
• Septic thrombophlebitis (a rare, potentially life-threatening blood clot in the internal jugular vein)

Seeing a healthcare provider promptly if you experience symptoms of parotitis is crucial to avoid these complications.

Parotitis involves the inflammation of the parotid glands due to various causes and presents with specific symptoms. Early diagnosis and treatment are vital to manage the condition effectively and prevent complications

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