What Parotitis Is
Parotitis describes the inflammation of one or both parotid glands, the largest of the body’s salivary glands. These glands are positioned on each side of the face, in front of and just below the ears. Their primary role involves producing and secreting saliva into the mouth, which aids in digestion and maintains oral health. When parotitis occurs, the affected gland typically swells, leading to discomfort and sometimes pain.
Common Causes
Parotitis can stem from various origins, with infections being the most frequent culprits. Viral infections are particularly common, especially the mumps virus, which historically caused widespread outbreaks of parotitis before widespread vaccination. Other viruses, such as influenza, parainfluenza, Epstein-Barr virus, and human immunodeficiency virus (HIV), can also induce parotid gland inflammation. These viral infections often lead to swelling in both parotid glands.
Bacterial infections represent another cause of parotitis, frequently occurring when salivary flow is reduced or obstructed. Staphylococcus aureus and Streptococcus species are common bacterial pathogens involved. These infections might arise from poor oral hygiene, dehydration, or blockages within the salivary ducts, creating an environment where bacteria can multiply. Bacterial parotitis often affects only one gland and can lead to more acute symptoms, including pus formation.
Beyond infections, non-infectious factors can also trigger parotitis. Autoimmune diseases, such as Sjögren’s syndrome, can cause chronic inflammation of the salivary glands, including the parotids. Blockages within the salivary ducts, often caused by salivary stones (sialoliths), can impede saliva flow and lead to inflammation. Certain medications, like some diuretics or antihistamines, can also reduce saliva production, increasing the risk of gland inflammation.
Recognizing Symptoms
The most noticeable symptom of parotitis is swelling in the area of the parotid gland, located just in front of and below the ear. This swelling can range from mild to significant, often making the side of the face appear puffy. Pain frequently accompanies the swelling, intensifying when chewing, swallowing, or opening the mouth wide. The discomfort may radiate to the ear, jaw, or neck.
Individuals with parotitis may also experience generalized signs of illness. A fever is common, particularly with infectious causes, alongside a general feeling of being unwell (malaise). Headaches can also occur. Some people report a dry mouth due to impaired salivary production from the inflamed glands. Difficulty opening the mouth, known as trismus, can develop if swelling affects the jaw muscles.
Diagnosis and Management
Diagnosing parotitis typically begins with a physical examination. A healthcare provider will visually inspect and gently feel the swollen area around the parotid glands and inquire about the patient’s medical history, including recent illnesses, vaccination status, and medications.
Diagnostic tests may be employed to identify the specific cause or rule out complications. Blood tests can detect signs of infection or inflammation. For suspected viral causes like mumps, specific antibody tests can confirm the diagnosis. Imaging techniques, such as ultrasound or CT scans, may be used to visualize the parotid gland, identify blockages like salivary stones, or detect abscesses.
Management of parotitis depends on its underlying cause. For viral parotitis, treatment is primarily supportive, focusing on symptom relief. This includes pain relievers, maintaining good hydration, and ample rest. Applying warm compresses to the swollen area can also help alleviate discomfort.
Bacterial parotitis usually requires antibiotics. In cases of blockages, such as those caused by salivary stones, management might involve methods to encourage stone passage, like salivary gland massage or increased fluid intake. Surgical intervention is rarely needed but may be considered for recurrent blockages or abscess drainage.