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Mayer M, Esser J, Walker SV, Shabli S, Lechner A, Canis M, Klussmann JP, Nachtsheim L, Wolber P. Bi-institutional analysis of microbiological spectrum and therapeutic management of parotid abscesses. Head Face Med 2024; 20:38. [PMID: 38997761 PMCID: PMC11241904 DOI: 10.1186/s13005-024-00438-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND A parotid abscess (PA) is a complication of an acute bacterial parotitis with a potentially life-threatening course. To date, data on the diagnosis and therapy of PA is sparse and mostly consists of case reports or case series. Therefore, this study aimed at comprehensively analyzing the microbiological spectrum and the therapeutic management in a bi-institutional setting. METHODS A retrospective clinical chart review was performed to identify all patients surgically treated for PA at two tertiary care centers in Germany. Data on demographics, clinical management and microbiological data including species identification, pathogenicity, type of antibiotic therapy, adjustment of antibiotics, antibiotic sensitivity testing, and smear test results were extracted. Intervention-related variables and etiology were analyzed for their statistical association with outcome variables. RESULTS Overall, 85 patients were included. Most patients (92.9%) underwent surgical incision. Around half of the patients (45.9%) were treated under local anesthesia. No facial nerve palsy was observed. The most frequently detected pathogens were Streptococci (n = 23), followed by Staphylococcus aureus (n = 6) including one case of methicillin-resistant Staphylococcus aureus. Most patients (68.2%) received an aminopenicillin ± beta-lactamase inhibitor as empiric antibiotic therapy. In 6 cases the antibiotic therapy was modified after receiving the antibiogram. Four patients (5.2%) presented with recurrent PA. Etiology was idiopathic (42.4%), followed by tumorous (12.9%), obstructive, and immunosuppressive (each 11.8%). Patients with a dental focus (p = 0.007) had a longer duration of hospitalization. CONCLUSION The results show that the surgical therapy of PA under local anesthesia is safe. A dental examination should routinely be performed to rule out a dental focus. Obtaining a microbiological specimen in order to modify antibiotic therapy if necessary and a histopathological specimen to rule out a tumorous etiology is obligate.
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Affiliation(s)
- Marcel Mayer
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany.
| | - Julia Esser
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Sarah Victoria Walker
- Institute for Medical Microbiology, Immunology and Hygiene, Medical Faculty, University of Cologne, Cologne, Germany
- Institute for Clinical Microbiology and Hospital Hygiene, RKH Regionale Kliniken Holding Und Services GmbH, Ludwigsburg, Germany
| | - Sami Shabli
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Axel Lechner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Munich, Munich, Germany
| | - Martin Canis
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Munich, Munich, Germany
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Lisa Nachtsheim
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Philipp Wolber
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
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Grinberg N, Whitefield S, Kleinman S, Frenkel G, Peleg O. Botulinum Toxin-Induced Parotitis: A Postoperative Complication Following Masseter Muscle Injection. J Oral Maxillofac Surg 2024; 82:525-530. [PMID: 38438110 DOI: 10.1016/j.joms.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 03/06/2024]
Abstract
Botulinum toxin (BTX) injection is a common treatment for bruxism, but there is no literature on potential salivary gland complications. This paper presents a case of acute parotitis in a 60-year-old female following BTX injections to the masseter muscle. This case highlights the possible salivary gland complications after injection of BTX into the masticatory muscles. An electronic search of PubMed and Embase databases was conducted to create a literature review in order to delve into the etiology behind the presented case and suggest potential preventive measures to avoid salivary gland complications. Thirty-one articles are reviewed and discussed. Currently, there is no consensus on the causes of the mentioned complication. However, various factors have been proposed, encompassing anatomical, physiological, biological, and physical aspects. Several methods have been recommended for the safe injection of BTX, which, along with better medical training and knowledge, are warranted to achieve predictable results.
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Affiliation(s)
- Nadav Grinberg
- Trainee, Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel; Physician, "Bina" Program, Medical Corps (IDF) and Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel.
| | - Sara Whitefield
- Attending Physician, Oral Medicine Unit, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shlomi Kleinman
- Head of Oral and Maxillofacial Surgery, Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Gal Frenkel
- Attending Physician, Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Oren Peleg
- Attending Physician, Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
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Choudhary T, Marzotto KN, Hutchings R. Post-endoscopy Parotitis in a 4-Year-Old. Clin Pediatr (Phila) 2024:99228241245337. [PMID: 38591863 DOI: 10.1177/00099228241245337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Affiliation(s)
- Tuhin Choudhary
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA, USA
| | - Kevin N Marzotto
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA, USA
| | - Rebecca Hutchings
- Department of Pediatric Emergency Medicine, Louisiana State University Health, New Orleans, LA, USA
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Hall AL, Matich E, Kulla A, Jaara M, De Marco D, Black NP. Idiopathic Parotid Gland Abscess in a Pediatric Patient. Cureus 2024; 16:e58464. [PMID: 38765350 PMCID: PMC11099563 DOI: 10.7759/cureus.58464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Parotid abscesses are sequelae of acute parotitis that are rare in pediatric patients. Common inciting causes of parotid abscesses include infection, inflammatory conditions, and ductal obstruction. This case presents a parotid abscess found in an otherwise healthy four-year-old girl. Further evaluation revealed no evidence of infection, no anatomical ductal obstruction, and no evidence of autoimmune conditions that could have caused the abscess. Nonetheless, the patient was treated with an incision and drainage procedure and antibiotic therapy with full recovery. Development of a parotid abscess with no identifiable cause is exceedingly rare with limited documented instances. From this case, idiopathic parotid abscesses may be considered as a diagnosis of exclusion after ruling out common causes, though management still follows the standard of care.
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Affiliation(s)
- Ariel L Hall
- Pediatrics, University of Florida College of Medicine, Gainesville, USA
| | - Erica Matich
- Pediatrics, University of Florida College of Medicine, Gainesville, USA
| | - Artenisa Kulla
- Pediatrics, University of Florida College of Medicine, Gainesville, USA
| | - Mahmoud Jaara
- Pediatrics, University of Florida Health, Gainesville, USA
| | | | - Nicole P Black
- Pediatrics, Pediatrix Medical Group, Orlando Health Winnie Palmer Hospital for Women & Babies, Orlando, USA
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Strassen U, Grimler C, Hofauer B. Ultrasound-Guided Needle Aspiration vs. Surgical Incision of Parotid Abscesses. J Clin Med 2022; 11:jcm11247425. [PMID: 36556042 PMCID: PMC9784587 DOI: 10.3390/jcm11247425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Standard treatment of parotideal abscesses consists of surgical drainage. This often has to be carried out in general anesthesia and carries the risk of iatrogenic injury of the facial nerve. Ultrasound-guided needle aspiration is an alternative therapy. Up until now a lack of systematic data concerning this subject exists. The study at hand aims to answer the question whether needle aspiration is a viable alternative for surgical drainage. METHODS All patients who had been treated surgically (n = 39) or via ultrasound-guided needle aspiration (n = 18) at our clinic were included into this monocentric retrospective analysis. RESULTS There was no statistically significant difference (p = 0.142) regarding the mean abscess volume in both groups (5.7 vs. 10.1 mL). Therapy of the abscesses on average required 1.88 (1-5) ultrasound-guided needle aspirations or 1.10 (1-4) surgical interventions. There was a trend to a shorter inpatient treatment period (5.88 vs. 7.33 days) after ultrasound-guided needle aspiration. This trend did not reach statistical significance (p = 0.301). Facial nerve alterations did not occur in any of the patients. Postoperative bleeding did never occur after needle aspirations but in 2% of the patients after surgical abscess revision. CONCLUSION Ultrasound-guided needle aspiration is safe and effective in the treatment of parotid abscesses.
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Oral Lesions in Children and Adolescents. Pediatr Dent 2022. [DOI: 10.1007/978-3-030-78003-6_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Srivanitchapoom C, Yata K. Clinical characteristics that predict parotid abscess: An observational cohort study. Ann Med Surg (Lond) 2021; 64:102230. [PMID: 33777393 PMCID: PMC7985271 DOI: 10.1016/j.amsu.2021.102230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 11/26/2022] Open
Abstract
Background We analysed clinical factors that are predictive of a diagnosis of parotid abscess among patients with bacterial parotitis. Material and methods This retrospective study included 64 hospitalised patients who were diagnosed with parotid abscess, or bacterial parotitis. Data on patient demographics, clinical characteristics, and clinical management were collected. Predictive factors for parotid abscess were evaluated using univariate and multivariate analysis. Results There were 25 patients with parotid abscess and 39 with bacterial parotitis. All patients presented with moderate-to-severe disease, required parenteral antibiotics, or had indicators for surgical drainage. Patient profiles and immune status were not significantly associated with parotid abscess. However, parameters that were significantly related to parotid abscess were subacute presentation (approximate 10.4 days) (p value = 0.016), fluctuation (p value < 0.001), and normal (haemoglobin) Hb level >12–13 g/dL (p value = 0.035). Imaging indicated the abscess location, extension and evaluated the complications. Surgical drainage with small skin incision and antibiotic coverage for possible pathogens, in particular Staphylococcus spp. and Streptococcus spp. produced favourable patient outcomes. Complication was identified in 3 cases with included septicaemia and cellulitis of the face and parapharyngeal space. Conclusions Among bacterial parotitis patients, parotid abscess should be considered in whom presented with subacute duration of symptoms, enlarged glands with fluctuation, and non-anaemic problem. Instead of standard skin incision of parotidectomy, small vertical skin incision over a well localised abscess pocket or fluctuated area achieved the good results. Parotid abscess should be considered in subacute duration of parotid enlargement. There was no related host immunity with parotid abscess formation. Favourable treatment outcome achieved from adequate drainage and proper antibiotics. Small vertical skin incision provided good results and no re-form an abscess.
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Gibson CJ, Narayan M, Barie PS. Acute Candida glabrata Parotitis with Fungemia after Major Pelvic Oncologic Surgical Procedure. Surg Infect (Larchmt) 2020; 22:354-355. [PMID: 32466720 DOI: 10.1089/sur.2020.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Cameron J Gibson
- Division of Trauma, Burns, Acute and Critical Care, Department of Surgery, Department of Medicine, Weill Cornell Medical Center, New York, New York, USA
| | - Mayur Narayan
- Division of Trauma, Burns, Acute and Critical Care, Department of Surgery, Department of Medicine, Weill Cornell Medical Center, New York, New York, USA
| | - Philip S Barie
- Division of Trauma, Burns, Acute and Critical Care, Department of Surgery, Department of Medicine, Weill Cornell Medical Center, New York, New York, USA.,Division of Medical Ethics, Department of Medicine, Weill Cornell Medical Center, New York, New York, USA
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Abstract
Infection of the neck is a relatively common emergency department complaint. If not diagnosed and managed promptly, it may quickly progress to a life-threatening infection. These infections can result in true airway emergencies that may require fiberoptic or surgical airways. This article covers common, as well as rare but emergent, presentations and uses an evidence-based approach to discuss diagnostic and treatment modalities.
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Affiliation(s)
- Renjie Michael Li
- Department of Emergency Medicine, Loma Linda University Medical Center, 11234 Anderson Street MC A-108, Loma Linda, CA 92354, USA
| | - Michael Kiemeney
- Department of Emergency Medicine, Loma Linda University School of Medicine, 11234 Anderson Street MC A-108, Loma Linda, CA 92354, USA.
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Infections and foreign bodies in ENT. SURGERY (OXFORD, OXFORDSHIRE) 2018; 36:553-559. [PMID: 32336859 PMCID: PMC7172438 DOI: 10.1016/j.mpsur.2018.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Infections of the ear, nose and throat are common. The majority of these infections are managed by the primary care physicians and they settle with conservative and medical management. However, a small group can progress to become troublesome and develop complications to the extent that they may require surgical intervention. Some of the infections can lead to life-threatening complications therefore awareness and correct diagnosis along with appropriate management is paramount. Foreign bodies in the ear, nose and throat are commonly encountered. The location and type of foreign body can have an implication on the urgency of action and the possible complications. In this article the common ENT infections and foreign bodies and their management are discussed.
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Patel P, Scott S, Cunningham S. Challenging Case of Parotitis: A Comprehensive Approach. J Osteopath Med 2018; 117:e137-e140. [PMID: 29181524 DOI: 10.7556/jaoa.2017.152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The diagnosis and management of parotitis can be challenging. Patients often present with pain and edema in the neck, jaw, head, and ear due to congestion of the gland. Parotitis is typically caused by an infection within the parotid gland and surrounding lymph nodes, and the infection can spread to nearby cervical fascial planes and cause major complications if not managed successfully. Specific guidelines for the outpatient management of parotitis are limited, and outpatient treatment failures are common, requiring inpatient therapy with multiple broad-spectrum antibiotics. In the current case, a comprehensive patient-centered approach was used to treat a woman whose overlapping clinical conditions, lifestyle, and work factors led to an infection of the parotid gland.
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12
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Benito Bernáldez C, Romero Muñoz C, Rodríguez Martín PJ. Parotiditis en una paciente con ventilación mecánica no invasiva. Med Clin (Barc) 2017; 149:179. [DOI: 10.1016/j.medcli.2017.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 02/15/2017] [Accepted: 02/16/2017] [Indexed: 10/19/2022]
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13
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Sellami M, Mnejja M, Masmoudi M, Maalej F, Charfeddine I, Ghorbel A. [The complicated acute bacterial parotitis in adults]. Presse Med 2017; 46:542-544. [PMID: 28483285 DOI: 10.1016/j.lpm.2017.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 03/08/2017] [Accepted: 03/13/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Moncef Sellami
- CHU Habib Bourguiba, service d'ORL et chirurgie cervicofaciale, route El Ain Km 0,5, 3029 Sfax, Tunisie.
| | - Malek Mnejja
- CHU Habib Bourguiba, service d'ORL et chirurgie cervicofaciale, route El Ain Km 0,5, 3029 Sfax, Tunisie
| | - Mohamed Masmoudi
- CHU Habib Bourguiba, service d'ORL et chirurgie cervicofaciale, route El Ain Km 0,5, 3029 Sfax, Tunisie
| | - Firas Maalej
- CHU Habib Bourguiba, service d'ORL et chirurgie cervicofaciale, route El Ain Km 0,5, 3029 Sfax, Tunisie
| | - Ilhem Charfeddine
- CHU Habib Bourguiba, service d'ORL et chirurgie cervicofaciale, route El Ain Km 0,5, 3029 Sfax, Tunisie
| | - Abdelmonem Ghorbel
- CHU Habib Bourguiba, service d'ORL et chirurgie cervicofaciale, route El Ain Km 0,5, 3029 Sfax, Tunisie
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Alaya S, Mofredj A, Tassaioust K, Bahloul H, Mrabet A. Acute Parotitis as a Complication of Noninvasive Ventilation. J Intensive Care Med 2016; 31:561-3. [DOI: 10.1177/0885066616636021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 02/08/2016] [Indexed: 12/29/2022]
Abstract
Several conditions, including oropharyngeal dryness, pressure sores, ocular irritation, epistaxis, or gastric distension, have been described during noninvasive ventilation (NIV). Although this technique has been widely used in intensive care units and emergency wards, acute swelling of the parotid gland remains a scarcely reported complication. We describe herein the case of an 82-year-old man who developed unilateral parotitis during prolonged NIV for acute heart failure. Intravenous antibiotics, corticosteroids, and adjusting the mask laces’ position allowed rapid resolution of clinical symptoms.
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Affiliation(s)
- S. Alaya
- Service de Réanimation, Centre Hospitalier Général, Salon de Provence, France
| | - Ali Mofredj
- Service de Réanimation, Centre Hospitalier Général, Salon de Provence, France
| | - K. Tassaioust
- Service de Réanimation, Centre Hospitalier Général, Salon de Provence, France
| | - H. Bahloul
- Service de Réanimation, Centre Hospitalier Général, Salon de Provence, France
| | - A. Mrabet
- Service de Réanimation, Centre Hospitalier Général, Salon de Provence, France
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15
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Moy M, Perrino M, Mandel L. Unilateral facial swelling. J Am Dent Assoc 2016; 147:586-9. [DOI: 10.1016/j.adaj.2016.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/12/2016] [Accepted: 03/08/2016] [Indexed: 11/28/2022]
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Parotitis Caused by Streptococcus anginosus Group in a Patient After Splenectomy. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2014. [DOI: 10.1097/ipc.0b013e31828941f4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chen S, Paul BC, Myssiorek D. An Algorithm Approach to Diagnosing Bilateral Parotid Enlargement. Otolaryngol Head Neck Surg 2013; 148:732-9. [DOI: 10.1177/0194599813476669] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective This contemporary review aims to categorize the disease entities that cause bilateral parotid enlargement and to develop a question-based algorithm to improve diagnosis of bilateral parotid masses. Data Sources A PubMed search for bilateral and parotid showed 818 results. Of these, 68 relevant studies were reviewed to compile a list of disease processes that can cause bilateral parotid enlargement. Review Methods A total of 22 diseases entities were reviewed. The disease processes were initially grouped into 6 categories based on etiology: sialadenosis, infection, neoplasm, autoimmune, iatrogenic, and miscellaneous. For each lesion, the incidence, history, and physical examination were compiled in a matrix. Conclusion After reviewing the matrix, it was clear that grouping diseases based on specific history and physical findings limits the differential diagnosis. The most important factors included disease incidence, timing of onset, nodular or diffuse, pain, and overlying skin changes. With this algorithm, the differential diagnosis can be limited from 28 to 7 or fewer likely diagnoses for a given presentation. Implications for Practice Bilateral parotid disease has a wide differential diagnosis with an expanding number of available tests. An algorithm, based solely on data obtained from the history and physical examination in the first patient encounter, may reduce the differential and aid the clinician in deciding on further workup and treatment. Following the algorithm presented here should allow the clinician to arrive at a diagnosis rapidly without ordering unnecessary tests and wasting resources.
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Affiliation(s)
- Si Chen
- Department of Otolaryngology–Head and Neck Surgery, New York University School of Medicine, New York, New York, USA
| | - Benjamin C. Paul
- Department of Otolaryngology–Head and Neck Surgery, New York University School of Medicine, New York, New York, USA
| | - David Myssiorek
- Department of Otolaryngology–Head and Neck Surgery, New York University School of Medicine, New York, New York, USA
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Lampropoulos P, Rizos S, Marinis A. Acute suppurative parotitis: a dreadful complication in elderly surgical patients. Surg Infect (Larchmt) 2012; 13:266-9. [PMID: 22913804 DOI: 10.1089/sur.2011.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Acute suppurative parotitis (ASP) is a severe infection seen particularly in elderly surgical patients. Factors that increase the risk of ASP include post-operative dehydration, debilitating conditions, and immunosuppressed states. METHOD Case report and literature review. RESULTS An 82-year-old female patient was admitted because of paralytic ileus, dehydration, and poor oral hygiene, and was in distress. After two days of hospitalization, the patient developed a progressive painful swelling of her right parotid gland and fever up to 39.0°C. Computed tomography scanning showed an abscess in the parotid gland. Because of her progressive clinical deterioration, the patient underwent operative drainage of the abscess and removal of the necrotic material. Unfortunately, she suffered multiple organ dysfunction syndrome and died. CONCLUSION Acute suppurative parotitis requires prompt aggressive treatment that nevertheless may fail.
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Davisson KW, Higgins GL, Nelson S. Elderly male with cheek swelling. Acute suppurative parotitis. Ann Emerg Med 2010; 57:71, 78. [PMID: 21183088 DOI: 10.1016/j.annemergmed.2009.12.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Revised: 12/03/2009] [Accepted: 12/28/2009] [Indexed: 11/26/2022]
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Abstract
The objective of this article is to provide the internist with general considerations when confronted with an adult patient presenting with a neck mass. A thorough gathering of historical information and a complete physical examination are crucial in developing a differential diagnosis for these patients. Specifically, the location of the mass, its time of onset, and duration are important because of the high likelihood of neoplastic processes in patients older than 40 years. The young adult patient has an increased incidence of inflammatory, congenital, and traumatic processes as causes of their neck mass, but again, neoplasms are not out of the realm of possibility. Judicious use of imaging studies, namely computed tomography scanning with contrast, is a valuable adjunct to the physical examination. Other than infectious etiology, referral to an otolaryngologist is frequently warranted to obtain a definitive diagnosis for the development of an appropriate treatment plan, which is predominantly surgical.
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Affiliation(s)
- Tara L Rosenberg
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39126, USA
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Belczak SQ, Cleva RD, Utiyama EM, Cecconello I, Rasslan S, Parreira JG. Acute postsurgical suppurative parotitis: current prevalence at Hospital das Clínicas, São Paulo University Medical School. Rev Inst Med Trop Sao Paulo 2008; 50:303-5. [DOI: 10.1590/s0036-46652008000500010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2007] [Accepted: 09/03/2008] [Indexed: 11/22/2022] Open
Abstract
Postsurgical acute suppurative parotitis is a bacterial gland infection that occurs from a few days up to some weeks after abdominal surgical procedures. In this study, the authors analyze the prevalence of this complication in Hospital das Clínicas/São Paulo University Medical School by prospectively reviewing the charts of patients who underwent surgeries performed by the gastroenterological and general surgery staff from 1980 to 2005. Diagnosis of parotitis or sialoadenitis was analyzed. Sialolithiasis and chronic parotitis previous to hospitalization were exclusion criteria. In a total of 100,679 surgeries, 256 patients were diagnosed with parotitis or sialoadenitis. Nevertheless, only three cases of acute postsurgical suppurative parotitis associated with the surgery were identified giving an incidence of 0.0028%. All patients presented with risk factors such as malnutrition, immunosuppression, prolonged immobilization and dehydration. In the past, acute postsurgical suppurative parotitis was a relatively common complication after major abdominal surgeries. Its incidence decreased as a consequence of the improvement of perioperative antibiotic therapy and postoperative support. In spite of the current low incidence, we believe it is important to identify risks and diagnose as quick as possible, in order to introduce prompt and appropriate therapeutic measures and avoid potentially fatal complications with the evolution of the disease.
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Mandel L. Differentiating Acute Suppurative Parotitis From Acute Exacerbation of a Chronic Parotitis: Case Reports. J Oral Maxillofac Surg 2008; 66:1964-8. [DOI: 10.1016/j.joms.2007.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2006] [Revised: 06/04/2007] [Accepted: 08/21/2007] [Indexed: 10/21/2022]
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Lee VK, Kimbrough DJ, Jarquin-Valdivia AA. Acute Bacterial Parotitis Following Acute Stroke. Infection 2008; 37:283-5. [DOI: 10.1007/s15010-007-6080-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2006] [Accepted: 10/24/2007] [Indexed: 12/22/2022]
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Lerman MA, Laudenbach J, Marty FM, Baden LR, Treister NS. Management of oral infections in cancer patients. Dent Clin North Am 2008; 52:129-53, ix. [PMID: 18154868 DOI: 10.1016/j.cden.2007.10.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The myelosuppressive and mucosal-damaging consequences of cancer and cancer therapies place patients at high risk for developing infectious complications. Bacterial, fungal, and viral infections are all commonly encountered in the oral cavity, contributing to both morbidity and mortality in this patient population. Prevention, early and definitive diagnosis, and appropriate management are critical to ensure optimal treatment outcomes. With the majority of cancer patients treated as outpatients in the community setting, oral health care professionals play an important role in managing such infectious complications of cancer therapy.
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Affiliation(s)
- Mark A Lerman
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
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