parotitis

Parotitis is inflammation of the parotid glands, the paired salivary glands located near the jaw and in front of the ears. It typically presents as swelling of one or both glands, with tenderness and reduced saliva production. The condition can be acute or chronic and may result from infection, autoimmunity, or duct obstruction.

Infectious parotitis is most often viral, with mumps historically the major cause in unvaccinated populations. Other viruses such as influenza, cytomegalovirus, or Epstein–Barr virus can also cause parotitis. Bacterial parotitis, usually due to Staphylococcus aureus, occurs especially in older or dehydrated patients and may present with fever and purulent drainage from the Stensen duct. Obstructive parotitis arises from salivary duct stones or strictures and tends to cause recurrent swelling around meals. Autoimmune parotitis, seen in conditions like Sjögren syndrome, is immune-mediated and often chronic.

Diagnosis relies on history and exam. Imaging such as ultrasound or CT can define gland edema or stones. Laboratory testing may include mumps PCR or serology when infection with mumps is suspected, and cultures of purulent drainage if bacteria are suspected.

Management depends on cause: viral parotitis is supportive—hydration, analgesia, warm compresses, and gland massage. Bacterial parotitis requires antibiotics effective against Staphylococcus aureus and good hydration; options include agents such as oxacillin or nafcillin and amoxicillin-clavulanate. Obstructive disease may require ductal care or stone removal. Autoimmune parotitis is treated by addressing the underlying autoimmune disorder.

Prognosis is generally favorable with treatment; viral forms resolve in days to weeks, bacterial infections respond to antibiotics. Prevention is aided by vaccination against mumps (MMR). Recurrent or chronic parotitis may require specialty evaluation.