module 4 parotitis Flashcards
parotitis
inflammatory reaction of the parotid gland
causes of parotitis
bacterial
viral
fungal
mycobacterial
Local primary infection of parotid
bacterial sialadenitis
systemic infection -> parotid inflammation
paramyxovirus (mumps)
acute suppurative sialadenitis (staph aureus)
chronic inflammatory conditions of parotid
mycobacterium tuberculosis
HIV
noninfective causes of parotitis
Sjogren syndrome
sarcoidosis
Acute suppurative parotitis
bacterial
most likely 60-79 years old
- Rx-induced (anticholinergic/antihistamine)
-> dec. in salivary flow
male more likely
right > left
Other factors assoc. with acute suppurative parotitis
chronic illness
- DM
- hypothyroidism
- renal failure
- RA
immunocompromised
poor oral hygiene
salivary duct obstruction
autoimmune disease
- Sjogren syndrome
recent surgical procedure
radiotherapy
hypovolemia
parotitis patho
Secretes serous salvia
- lacks lysosomes, immunoglobulin A, sialic acid: bacteriostatic
-> predisposed to great risk of infection
Retrograde migration of oral cavity flora through Stensen duct
Stasis of saliva
Ductal obstruction
Dec. stimulation os saliva
Dec. mastication
Poor oral hygiene
parotitis clinical manifestations
rapid onset
- localized pain
- edema
- induration of the infected gland
- fever
- chills
- anorexia
- malaise
viral inflammatory parotitis clinical manifestations
edema: usually bilateral
pain: exacerbated by mastication
bacterial parotitis clinical manifestations
acute suppurative sialadenitis
hypovolemic
unilateral parotid enlargement and cellulitis
intraoral: pus visualized with manual pressure on parotid duct
chronic inflammatory parotitis TB clinical manifestations
enlargement and pain in affected gland
mass usually unilateral
assoc. with matted lymph nodes
chronic inflammatory parotitis HIV clinical manifestations
bilaterally enlarged, painless parotid glands
gradually produce smaller amounts of saliva
-> xerostomia
parotitis physical exam
bimanual palpation of gland: stensen duct
- Bacterial: elicits suppurative discharge
- Viral: bilateral edema, clear discharge
parotitis management
culture and sensitivity
IV antibiotics
fluid and electrolyte replacement
proper oral hygiene
sialagogues
Juvenile recurrent parotitis
parotitis in peds population:
- 4mo to 15 years old
recurrent inflammation of parotid gland, unilateral or bilateral
Juvenile recurrent parotitis clinical manifestation
inflammation of parotid gland
pain
dec. function of gland
erythema
fever
parotitis complications
abscess formation
dec. eating and drinking
-> inc. risk hypovolemia and further compromising pt
viral parotitis complications
orchitis
pancreatitis
meningoencephalitis
deafness
