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Acquired Oral Findings, continued
Parotitis
Parotitis is the clinical term for inflammation and swelling of the parotid gland. With parotitis, the parotid gland is tender to palpation and the opening to Stenson’s duct appears inflamed and swollen.

Viral Causes of Parotitis
Mumps is the classic virus known to cause parotitis. Mumps parotitis is bilateral in 70% of cases and usually follows a 1-2 day prodrome of fever, headache, emesis, and myalgias. 

Bacterial Causes of Parotitis
Called “purulent parotitis�, bacterial infection of the parotid gland is typically unilateral and extremely painful with visible pus draining from Stenson’s duct. The patient often appears ill and should be empirically treated with antibiotics after culture obtained.

Obstruction
Parotitis from obstruction is typically the result of a salivary stone or sialolith, which is expected to be unilateral. If the patient is not ill, expectant management for passage of the sialolith is appropriate.

Other Conditions
Other conditions that can result in parotid gland
enlargement (with or without inflammation) include:

  • Bulimia or other causes of chronic emesis
  • Diabetes
  • Collagen vascular diseases
  • Local radiation treatment
 
 
Mumps parotitis is typically bilateral and associated with systemic symptoms.
 
Staph aureus is the most common cause of bacterial parotitis.
 
Parotitis from a sialolith does not require any specific treatment unless superinfection occurs.


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