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Parotitis

Basics

Parotitis is inflammation or infection of the parotid salivary gland. This is the main salivary gland, and lies under the angle of the jaw and the ear lobe. If it is swollen, the ear is pushed up and out in a characteristic fashion, which helps differentiate this condition from a simple lymph gland infection (lymphadenitis) in the same area. The most common cause of parotitis is now, bacterial infection, since mumps has all but disappeared due to near-universal immunization. Most mumps you hear of will not be mumps but non-mumpsvirus parotitis, bacterial parotitis, or most likely, lymphadenitis.

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Symptoms

If it is swollen, the ear is pushed up and out in a characteristic fashion, which helps differentiate this condition from a simple lymph gland infection (lymphadenitis) in the same area.

Prevention

In many cases, salivary gland infections cannot be prevented. Good oral hygiene may prevent some cases of bacterial infection.

Causes

The most common cause of parotitis is now bacterial infection, since mumps has all but disappeared due to near-universal immunization. Most mumps you hear of will not be mumps but non-mumpsvirus parotitis, bacterial parotitis, or most likely, lymphadenitis. The opening of the salivary duct (Stensen's duct) can be inspected for clues to the cause of parotitis. It is a perhaps 2 mm diameter raised bump with a tiny central hole lying on the mucous membrane of the inner cheek. Your doctor will observe this opening and massage the cheek, stroking forward from the ear toward the front of the face. If the little opening is raised and red but nothing comes from the duct with stroking but saliva, the diagnosis is probably viral parotitis. Viruses other than the mumps virus can cause parotitis. If the infection is bacterial, pus will exude from the duct with stroking. An antibiotic active against Staph. aureus will be prescribed.

Diagnosis

In some cases, no treatment is necessary. If there is pus or a fever, or if the infection is known or presumed to be bacterial, antibiotics may be prescribed. Antibiotics are not effective against viral infections. Good oral hygiene, with thorough tooth brushing and flossing at least twice per day, may aid healing and help prevent an infection from spreading. Warm salt water rinses (1/2 teaspoon of salt in one cup of water) may be soothing and keep the mouth moist.

Dietary Guidelines

Warm salt-water rinses (1/2 teaspoon of salt in one cup of water) may be soothing and keep the mouth moist.

Mind/Body Considerations

Good oral hygiene, with thorough tooth brushing and flossing at least twice per day, may aid healing and help prevent an infection from spreading.

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