Parotitis causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The cause of parotitis can be due to infection, autoimmune origin, blockage of the parotid duct or some diseases of uncertain etiology.
The most common bacterial cause is S. aureus. S. pneumonia, S. pyogenes, and H. influenza are also common. Less commonly gram negative rods (GNR) as well as anaerobes are found. M. tuberculosis and T. pallidum have also been reported but are usually associated with chronic, painless infection. Viral etiologies include paramyxovirus (particularly Mumps), influenza, parainfluenza, echovirus, and coxsackie. Cytomegalovirus (CMV) and adenovirus have been implicated in HIV patients. Nonbacterial causes include Wegener’s granulomatosis and lymphoma. Cat-scratch and actinomycosis should be considered if the patient fails to respond to standard therapy. This predisposes to parotitis.[1]
Causes
Infection
- Acute viral parotitis
- Acute bacterial parotitis:*
- The most common cause of bacterial parotitis is Staphylococcus aureus[2]
- Other bacterial causes of parotitis include the following:
- Extrapulmonary tuberculosis
- Parotitis can result as a symptom of acute tuberculosis[4]
Autoimmune Causes
- Sjögren's Syndrome
- Parotitis can result from Sjögren's syndrome due to chronic inflammation of the parotid gland.[5]
Blockage
- Parotitis can result from the following forms of blockages:
- Sialolithiasis: salivary gland calcified stones, causing parotid gland inflammation.[6]
- Mucous plugs[7]
- Benign or malignant neoplasia.[8]
Diseases of uncertain etiology
Chronic nonspecific parotitis: This term is generally used for patients in whom no definite etiology is found. Episodes may last for several days, paralleling the time course of a bacterial or viral illness. Others may experience episodes that last only a few hours from onset to resolution. Some episodes may last for several weeks. Quiescent periods between episodes last for hours, days, or even years.[9]
Recurrent parotitis of childhood: An uncommon syndrome in which recurring episodes clinically resembling mumps. Generally, episodes begin by age 5 years, and virtually all patients become asymptomatic by age 10–15 years. The duration of attacks averages 3–7 days but may last 2–3 weeks in some individuals. The spectrum varies from mild and infrequent attacks to episodes so frequent that they prevent regular school attendance. Local heat applied to the gland, massaging the gland from back to front, and taking penicillin usually cure individual episodes. Treatment of individual infections may prevent injury to the gland parenchyma. Severe disease may be treated by parotidectomy.[9]
Sialadenosis (sialosis): In this disorder, both parotid glands may be diffusely enlarged with only modest symptoms. Patients are aged 20–60 years at onset, and the sexes are equally involved. The glands are soft and non-tender. Approximately half of the patients have endocrine disorders such as diabetes, nutritional disorders such as pellagra or kwashiorkor, or have taken drugs such as guanethidine, thioridazine, or isoprenaline.
Sarcoidosis: The lungs, skin, and lymph nodes are most often affected, but the salivary glands are involved in approximately 10% of cases. Bilateral firm, smooth, and non-tender parotid enlargement is classic. Xerostomia occasionally occurs. The Heerfordt-Waldenstrom syndrome consists of sarcoidosis with parotid enlargement, fever, anterior uveitis, and facial nerve palsy.[9]
Pneumoparotitis: Air within the ducts of the parotid gland with or without inflammation. The duct orifice normally functions as a valve to prevent air from entering the gland from a pressurized oral cavity. Rarely, an incompetent valve allows insufflation of air into the duct system. Pneumoparotitis most commonly occurs in wind instrument players, glass blowers, and scuba divers.[9]
Several lymph nodes reside within the parotid gland as a superficial and deep group of nodes. These nodes may be involved with any process that affects lymph nodes, including bacterial, fungal, viral, and neoplastic processes. Rarely, drugs such as iodides, phenylbutazone, thiouracil, isoproterenol, heavy metals, sulfisoxazole, and phenothiazines cause parotid swelling.
References
- ↑ McQuone SJ. Acute Viral and Bacterial Infections of the Salivary Glands. Otolaryngologic Clinics of North America. 1999, 32:793-811.PMID 10477787
- ↑ 2.0 2.1 "Salivary gland infections: MedlinePlus Medical Encyclopedia".
- ↑ Brook I (1992). "Diagnosis and management of parotitis". Arch. Otolaryngol. Head Neck Surg. 118 (5): 469–71. PMID 1571113.
- ↑ Henderson SO, Mallon WK (1995). "Tuberculosis as the cause of diffuse parotitis". Ann Emerg Med. 26 (3): 376–9. PMID 7661432.
- ↑ "Fast Facts About Sjogren's Syndrome".
- ↑ Hernandez S, Busso C, Walvekar RR (2016). "Parotitis and Sialendoscopy of the Parotid Gland". Otolaryngol. Clin. North Am. doi:10.1016/j.otc.2015.12.003. PMID 26912292.
- ↑ Capaccio P, Torretta S, Ottavian F, Sambataro G, Pignataro L (2007). "Modern management of obstructive salivary diseases". Acta Otorhinolaryngol Ital. 27 (4): 161–72. PMC 2640028. PMID 17957846.
- ↑ Bussu F, Parrilla C, Rizzo D, Almadori G, Paludetti G, Galli J (2011). "Clinical approach and treatment of benign and malignant parotid masses, personal experience". Acta Otorhinolaryngol Ital. 31 (3): 135–43. PMC 3185824. PMID 22058591.
- ↑ 9.0 9.1 9.2 9.3