Infectious Disease Compendium

Parotitis

Diagnosis

Inflammation of the parotid gland. Bilateral should make you think of mumps or toxic.

Epidemiologic Risks

Salivary stones as outpatient, intubation as inpatient.

Microbiology

Outpatient: Streptococci (all) and S. aureus. In the US most parotitis is NOT mumps:

"Of 101 specimens, 38 were positive for a single virus: Epstein-Barr virus (23), human herpesvirus (HHV)-6B (10), human parainfluenza virus (HPIV)-2 (3), HPIV-3 (1), and human bocavirus (1). Mumps virus, enteroviruses (including human parechovirus), HHV-6A, HPIV-1, and adenoviruses were not detected (PubMed)."  Influenza A can also be a cause.

Inpatient: S. aureus. and gram negative rods such as Pseudomonas.

Empiric Therapy

Outpatient cephalexin OR dicloxacillin or even amoxicillin/clavulanate. Inpatient: third generation cephalosporins +/- vancomycin.

Pearls

Call ENT to help drain, especially if she is a sourpuss; lemons can make the saliva flow and help drain the pus.

Rants