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Head and Neck
Diagnosis
Parotid Space
Infectious and Inflammatory Lesions
Acute Parotitis
Acute Parotitis
Bernadette L. Koch, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Acute sialadenitis

          • Definitions

            • Acute inflammation of parotid gland
              • Bacterial: Localized infection may become suppurative with central abscess
              • Viral: Usually from systemic viral infection
              • Calculus induced: Ductal obstruction by sialolith
              • Autoimmune: Acute episode of chronic disease
              • Juvenile recurrent parotitis (JRP) or chronic recurrent parotitis of childhood: Intermittent idiopathic episodes of parotid inflammation

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Other Modality Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Fisher J et al: COVID-19 associated parotitis. Am J Emerg Med. 39:254.e1-3, 2021
                                        2. Lechien JR et al: Parotitis-like symptoms associated with COVID-19, France, March-April 2020. Emerg Infect Dis. 26(9), 2020
                                        3. Schiffer BL et al: Sjögren's syndrome in children with recurrent parotitis. Int J Pediatr Otorhinolaryngol. 129:109768, 2020
                                        4. Papadopoulou-Alataki E et al: Juvenile recurrent parotitis: the role of sialendoscopy. Int J Inflam. 2019:7278907, 2019
                                        5. Tucci FM et al: Juvenile recurrent parotitis: diagnostic and therapeutic effectiveness of sialography. Retrospective study on 110 children. Int J Pediatr Otorhinolaryngol. 124:179-84, 2019
                                        6. Guerin JB et al: Pediatric parotid region lesions: an imaging review. Neurographics. 8(6):394-412, 2018
                                        7. Inarejos Clemente EJ et al: Imaging evaluation of pediatric parotid gland abnormalities. Radiographics. 38(5):1552-75, 2018
                                        8. Abdel Razek AA et al: Imaging of sialadenitis. Neuroradiol J. 30(3):205-15, 2017
                                        9. Ramakrishna J et al: Sialendoscopy for the management of juvenile recurrent parotitis: a systematic review and meta-analysis. Laryngoscope. 125(6):1472-9, 2015
                                        10. Roby BB et al: Treatment of juvenile recurrent parotitis of childhood: an analysis of effectiveness. JAMA Otolaryngol Head Neck Surg. 141(2):126-9, 2015
                                        11. Francis CL et al: Pediatric sialadenitis. Otolaryngol Clin North Am. 47(5):763-78, 2014
                                        12. Ismail EA et al: Neonatal suppurative parotitis over the last 4 decades: report of three new cases and review. Pediatr Int. 55(1):60-4, 2013
                                        13. Kristensen RN et al: Facial nerve palsy caused by parotid gland abscess. J Laryngol Otol. 126(3):322-4, 2012
                                        14. Lampropoulos P et al: Acute suppurative parotitis: a dreadful complication in elderly surgical patients. Surg Infect (Larchmt). 13(4):266-9, 2012
                                        15. Cascarini L et al: Epidemiology of salivary gland infections. Oral Maxillofac Surg Clin North Am. 21(3):353-7, 2009
                                        16. Saarinen RT et al: Cases presenting as parotid abscesses in children. Int J Pediatr Otorhinolaryngol. 71(6):897-901, 2007
                                        17. Shanley JD: The resurgence of mumps in young adults and adolescents. Cleve Clin J Med. 74(1):42-4, 47-8, 2007
                                        18. Spiegel R et al: Acute neonatal suppurative parotitis: case reports and review. Pediatr Infect Dis J. 23(1):76-8, 2004
                                        19. Brook I: Acute bacterial suppurative parotitis: microbiology and management. J Craniofac Surg. 14(1):37-40, 2003
                                        20. Fattahi TT et al: Management of acute suppurative parotitis. J Oral Maxillofac Surg. 60(4):446-8, 2002
                                        21. Mandel L et al: Bilateral parotid swelling: a review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 93(3):221-37, 2002
                                        22. Yousem DM et al: Major salivary gland imaging. Radiology. 216(1):19-29, 2000
                                        23. Cohen MA et al: Acute suppurative parotitis with spread to the deep neck spaces. Am J Emerg Med. 17(1):46-9, 1999
                                        24. McQuone SJ: Acute viral and bacterial infections of the salivary glands. Otolaryngol Clin North Am. 32(5):793-811, 1999
                                        25. Pang YT et al: Acute suppurative parotitis and facial paralysis. J Laryngol Otol. 110(1):91-2, 1996
                                        26. Nusem-Horowitz S et al: Acute suppurative parotitis and parotid abscess in children. Int J Pediatr Otorhinolaryngol. 32(2):123-7, 1995
                                        27. Brook I: Diagnosis and management of parotitis. Arch Otolaryngol Head Neck Surg. 118(5):469-71, 1992
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Acute sialadenitis

                                                • Definitions

                                                  • Acute inflammation of parotid gland
                                                    • Bacterial: Localized infection may become suppurative with central abscess
                                                    • Viral: Usually from systemic viral infection
                                                    • Calculus induced: Ductal obstruction by sialolith
                                                    • Autoimmune: Acute episode of chronic disease
                                                    • Juvenile recurrent parotitis (JRP) or chronic recurrent parotitis of childhood: Intermittent idiopathic episodes of parotid inflammation

                                                IMAGING

                                                • General Features

                                                  • CT Findings

                                                    • MR Findings

                                                      • Ultrasonographic Findings

                                                        • Other Modality Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Fisher J et al: COVID-19 associated parotitis. Am J Emerg Med. 39:254.e1-3, 2021
                                                                              2. Lechien JR et al: Parotitis-like symptoms associated with COVID-19, France, March-April 2020. Emerg Infect Dis. 26(9), 2020
                                                                              3. Schiffer BL et al: Sjögren's syndrome in children with recurrent parotitis. Int J Pediatr Otorhinolaryngol. 129:109768, 2020
                                                                              4. Papadopoulou-Alataki E et al: Juvenile recurrent parotitis: the role of sialendoscopy. Int J Inflam. 2019:7278907, 2019
                                                                              5. Tucci FM et al: Juvenile recurrent parotitis: diagnostic and therapeutic effectiveness of sialography. Retrospective study on 110 children. Int J Pediatr Otorhinolaryngol. 124:179-84, 2019
                                                                              6. Guerin JB et al: Pediatric parotid region lesions: an imaging review. Neurographics. 8(6):394-412, 2018
                                                                              7. Inarejos Clemente EJ et al: Imaging evaluation of pediatric parotid gland abnormalities. Radiographics. 38(5):1552-75, 2018
                                                                              8. Abdel Razek AA et al: Imaging of sialadenitis. Neuroradiol J. 30(3):205-15, 2017
                                                                              9. Ramakrishna J et al: Sialendoscopy for the management of juvenile recurrent parotitis: a systematic review and meta-analysis. Laryngoscope. 125(6):1472-9, 2015
                                                                              10. Roby BB et al: Treatment of juvenile recurrent parotitis of childhood: an analysis of effectiveness. JAMA Otolaryngol Head Neck Surg. 141(2):126-9, 2015
                                                                              11. Francis CL et al: Pediatric sialadenitis. Otolaryngol Clin North Am. 47(5):763-78, 2014
                                                                              12. Ismail EA et al: Neonatal suppurative parotitis over the last 4 decades: report of three new cases and review. Pediatr Int. 55(1):60-4, 2013
                                                                              13. Kristensen RN et al: Facial nerve palsy caused by parotid gland abscess. J Laryngol Otol. 126(3):322-4, 2012
                                                                              14. Lampropoulos P et al: Acute suppurative parotitis: a dreadful complication in elderly surgical patients. Surg Infect (Larchmt). 13(4):266-9, 2012
                                                                              15. Cascarini L et al: Epidemiology of salivary gland infections. Oral Maxillofac Surg Clin North Am. 21(3):353-7, 2009
                                                                              16. Saarinen RT et al: Cases presenting as parotid abscesses in children. Int J Pediatr Otorhinolaryngol. 71(6):897-901, 2007
                                                                              17. Shanley JD: The resurgence of mumps in young adults and adolescents. Cleve Clin J Med. 74(1):42-4, 47-8, 2007
                                                                              18. Spiegel R et al: Acute neonatal suppurative parotitis: case reports and review. Pediatr Infect Dis J. 23(1):76-8, 2004
                                                                              19. Brook I: Acute bacterial suppurative parotitis: microbiology and management. J Craniofac Surg. 14(1):37-40, 2003
                                                                              20. Fattahi TT et al: Management of acute suppurative parotitis. J Oral Maxillofac Surg. 60(4):446-8, 2002
                                                                              21. Mandel L et al: Bilateral parotid swelling: a review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 93(3):221-37, 2002
                                                                              22. Yousem DM et al: Major salivary gland imaging. Radiology. 216(1):19-29, 2000
                                                                              23. Cohen MA et al: Acute suppurative parotitis with spread to the deep neck spaces. Am J Emerg Med. 17(1):46-9, 1999
                                                                              24. McQuone SJ: Acute viral and bacterial infections of the salivary glands. Otolaryngol Clin North Am. 32(5):793-811, 1999
                                                                              25. Pang YT et al: Acute suppurative parotitis and facial paralysis. J Laryngol Otol. 110(1):91-2, 1996
                                                                              26. Nusem-Horowitz S et al: Acute suppurative parotitis and parotid abscess in children. Int J Pediatr Otorhinolaryngol. 32(2):123-7, 1995
                                                                              27. Brook I: Diagnosis and management of parotitis. Arch Otolaryngol Head Neck Surg. 118(5):469-71, 1992