Parotitis is inflammation of the parotid gland, the large salivary gland in front of the ear. Mumps is the classic viral cause, while bacterial parotitis, often from Staphylococcus aureus, affects dehydrated, older or postoperative patients.
Key symptoms
- Painful swelling in front of and below the ear
- Pain that gets worse when eating
- Fever and malaise
- Dry mouth or a bad taste
- Trouble opening the mouth fully
What you find on exam
- Tender, warm, swollen parotid gland on one or both sides
- Pus from the Stensen duct opening on gland massage (bacterial)
- Hydration and oral hygiene
- Facial nerve function
- Testicular or ovarian pain in mumps
Tests
- Mostly a clinical diagnosis
- Culture of pus from the duct
- Mumps PCR from a buccal swab, or serology, if a viral cause is suspected
- Ultrasound or CT if an abscess or stone is suspected
- Blood count; amylase may be high
Treatment basics
- Hydration, warm compresses and gland massage
- Sour candies to increase saliva flow
- Bacterial: antibiotics that cover staph, such as amoxicillin-clavulanate; add vancomycin if MRSA risk
- Pain control with acetaminophen or ibuprofen
- Drainage if an abscess forms; isolation for mumps
Red flags
- Fluctuant swelling that suggests an abscess
- Facial nerve weakness
- Trouble breathing or swallowing, or spreading neck swelling
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.