Acute Infective Parotitis

Epidemiology

As a group, viral and bacterial infection forms the most common group of salivary gland disease. Mumps is caused by a ribonucleic acid paramyxovirus, and it predominantly affects the parotid glands. Unilateral parotid involvement may be seen in 20 to 30% of patients. Other viruses that may infect the parotid glands include influenza, parainfluenza, herpesvirus, and echovirus. Acute bacterial infection is usually due to ascending infection from the oral cavity. Most patients with ascending bacterial infection have predisposing factors such as dehydration, trauma, stones, and previous irradiation.

Clinical Findings

Mumps produces painful swelling of the parotid glands. The viral infection may be confined to the salivary tissues but may also cause epididymo-orchitis, meningoencephalitis, pancreatitis, and thyroiditis. Acute bacterial infection also produces a diffuse painful swelling, and pus may be seen in the opening of the parotid duct. Bacterial parotitis is usually a disease seen in debilitated patients. It is a known complication of dehydration following major surgery. Uncontrolled bacterial infection leads to abscess formation.