What Are the Common Causes of Parotid Swelling?

The parotid gland is the largest gland in the salivary glands. It is located near the earlobe on both sides of the cheek. The swelling of the parotid gland is centered on the earlobe and can be on one or both sides. The cause is infectious, immune, obstructive, and unexplained inflammation and enlargement. The most common is mumps caused by infection, which is more common in bacteria and viruses. Bacterial mumps is mainly manifested as fever, local redness, swelling, heat, and pain in the parotid gland, increased white blood cell counts, and the disease enters the suppurative stage. Squeezing the parotid gland shows that the pus flows out of the duct. Viral mumps, most commonly mumps, and mumps caused by other viral infections can also be seen. Mumps is a respiratory infectious disease caused by mumps virus infection. It is characterized by non-purulent swelling of the parotid glands and can invade various glandular tissues or nervous system and almost all organs such as liver, kidney, heart, joints, etc., often causing Meningoencephalitis, orchitis, ovarian inflammation, pancreatitis and other complications, can obtain lasting immunity after illness.

Basic Information

English name

parotitis

Visiting department

Stomatology

Common locations

Parotid gland

Common causes

Infection, immunity, blockage, medication, etc.

Causes of Mumps

Infectious

Acute bacterial mumps (purulent mumps): caused by a bacterial infection, mainly Staphylococcus aureus, followed by Streptococcus. Common causes are those with reduced parotid secretion (such as those with reduced body resistance and oral biological immunity, surgical fasting, etc.), parotid duct blockage, parotid lymphadenitis, and inflammation of adjacent tissues.

Viral mumps: common mumps virus, herpes simplex virus, coxsackie virus, influenza A virus, etc. can also be seen. Mumps infection is the most common cause of mumps.

2. Immunity

Such as Sjogren's syndrome, Mikulich disease, etc. can cause chronic autoimmune mumps.

3. blocked

The main parotid ducts and branches are blocked and then cause bacterial infection. Salivary stones, mucus plugs and rare tumors are more common, and benign tumors are more common.

4. Etiology unknown

Chronic non-specific mumps, recurrent mumps in children, and degenerative salivary gland enlargement are rarely caused by certain drugs.

Clinical manifestations of mumps

Purulent mumps

Often unilateral involvement, bilateral simultaneous occurrence is rare. In the early stage of inflammation, the symptoms are mild or inconspicuous, and the parotid area is slightly painful, swollen, and tender. The mouth of the catheter was slightly swollen and painful. As the disease progresses, fever, chills, and unilateral parotid pain and swelling may occur. The parotid glands and surface skin are locally red, swollen, hot, and painful. When the lesion enters the purulent stage, the parotid gland is squeezed to see that the pus flows out from the mouth of the catheter.

2. Mumps

Viral mumps is the most common mumps. Mumps is an infectious disease. The source of infection is patients and recessive infections. The route of transmission is respiratory droplets and close contact. The onset of clinical symptoms is rapid, often with precursor symptoms such as fever, headache, and poor appetite. After a few hours to 1 to 2 days, the body temperature can rise to above 39 ° C. Swelling of the salivary glands occurs, and the parotid glands are most commonly involved. The enlargement is generally centered on the earlobe, and develops forward, backward, and downward. When chewing and eating acidic diet, the pain is aggravated, the local skin is hot, and the tension is bright but not red. Usually the parotid glands on one side affect the contralateral side within 2 to 4 days. The submandibular or sublingual glands can also be affected. When the sublingual glands are enlarged, swelling of the tongue and neck can be seen, and swallowing difficulties can occur. The parotid orifice may be red and swollen at an early stage, which is helpful for diagnosis. Atypical cases can always be without parotid swelling, but with symptoms of simple orchitis and meningoencephalitis, there are only swelling of the submandibular or sublingual glands.

3. Autoimmune Mumps

It is more common in chronic autoimmune diseases, such as Sjögren's syndrome and IgG4-related diseases. In addition to recurrent parotid enlargement, other glands, joints, and organs are involved and damaged.

Mumps diagnosis

Purulent mumps

According to the clinical manifestations and signs (local swelling and pain in the parotid gland, pus outflow from the parotid gland when the parotid gland is squeezed, usually unilaterally,). The total number of blood routine leukocytes increased, the proportion of neutrophils increased significantly, the nucleus shifted to the left, and clinical diagnosis was not difficult. Taking a pus from the parotid duct for bacterial culture can confirm the diagnosis.

2. Mumps

According to the epidemic situation and the patient's contact history, fever, swelling of the parotid glands centered on the earlobe, local skin fever, tension and shiny but the skin is not red, can usually involve the contralateral parotid glands, pain when chewing and eating acidic diet can increase Other salivary glands, pancreas, testis, or central nervous system. Checking the blood routine routine white blood cell count is normal and decreased (who with orchitis can increase the white blood cell count), hematuria amylase increased, can make a clinical diagnosis. Specific mumps antibody IgM is positive (without a vaccine within 1 month), and the mumps virus antibody IgG is more than 4 times higher (including antibody positive conversion) during the recovery and acute phases, which can confirm the diagnosis.

Need to be distinguished from other autoimmune mumps, chronic non-specific mumps, symptomatic mumps, allergic mumps, etc., generally accompanied by corresponding clinical manifestations, mostly bilateral, generally without symptoms of acute infection, local also No obvious pain and tenderness.

Mumps Treatment

Purulent mumps

(1) Correct the water, electrolyte and acid-base balance for the treatment of the cause.

(2) Use effective antibacterial drugs, empirically apply large-dose penicillin or first- and second-generation cephalosporins to antibiotics against gram-positive cocci, and take pus from the mouth of parotid duct for bacterial culture and drug sensitivity. Sensitive adjustment for sensitive antibiotics.

(3) For other conservative treatments, hot compress, physical therapy, and external application can be used in the early stage of inflammation. Mouthwashes such as sodium bicarbonate solution and goutai can help control inflammation.

(4) Conservative medical treatment is ineffective, and incision and drainage should be performed when it develops to suppuration.

2. Mumps

(1) Isolate and rest in bed until the swelling of the parotid gland completely subsides. Keep your mouth clean, avoid acidic foods, and ensure fluid intake.

(2) symptomatic treatment is the main, antibiotics are not effective. Try ribavirin. It has been reported that interferon seems to be effective.

(3) Adrenal corticosteroid treatment has no positive effect. For severe or complicated meningoencephalitis and myocarditis, short-term use may be considered.

(4) Local irradiation of helium-neon laser for treating mumps has certain effects on pain relief and swelling.

(5) Male adult patients use diethylstilbestrol in the early stage of the disease to prevent orchitis.

(6) Chinese medicine and traditional Chinese medicine: Oral administration is mainly based on Puji disinfection and decoction. Topical use of purple gold tablets or Qingdai powder vinegar, 1 times a day.

Mumps prevention

Purulent mumps

Maintaining oral hygiene is an important part of preventing its onset. Some patients with weak constitution, prolonged bed rest, high fever or fasting can often suffer from dehydration. Oral care should be strengthened (such as careful tooth brushing, common chlorhexidine solution, mouthwash, etc.), maintain fluid balance, strengthen nutrition and anti-infective treatment.

2. Mumps

(1) Isolate the patient at an early stage until the parotid swelling subsides completely. Contacts generally do not require quarantine, but they should be held for three weeks in collective children's institutions, troops, etc. Suspicious persons should be temporarily quarantined immediately.

(2) Cut off the transmission route and ventilate the quilt.

(3) Protection of susceptible people Passive immunity: Mumps has a certain role in high-value immunoglobulin, but the source is difficult and it is not easy to popularize. The preventive effect of general globulin on the disease is questionable. Autoimmunity: At present, the triple vaccines of measles, mumps and rubella have a good immune effect. They belong to the national immunization plan. The first species are 8 months old and 18 to 24 months old. Each dose is injected subcutaneously or intramuscularly.