Parotitis

Definition:-
Parotitis is information of the parotid salivary gland.
Incidence:-
The incidence of parotits has been reported to be 0.01%of post operative patients .acute bacterial parotitis occurs mostly in neonates and in elderly ordebititated persons with systemic illness or after surgery.
Cause:-.viral infection from:-HIV ,mumps. bacterial infections from:-medications that cause dry mouth,when your flow of saliva
Is reduce , bacteria can collect and growth in the parotid duct.
. Dehydration
.poor oral hygiene
.sialoliths
.sjogren’s syndrome
.truma-can block flow of saliva (usually not cancerous).
.pheumoparotits -air air gets in to the ducts of the parotid gland ,most commonly occurs in wind instruments players ,glass blowers ,and scuba divies.. causative agents:-
. staphylococcus aureus is the most common bacterial pathogen viral parotitis is more common word wide then bacteria parotits with mumps being the most common viral cause of parotits in children.Predisposing conditions:-
. Dehydration malnutrition, immunosuppression,dental infection, tracheostomy, medication , that suppress salivary flow (antihistamines ,diuretics , anticholinergic medication.)Sign and symptoms:-
.There is sudden on set of indurated ,warm , erythematous swelling of the pre-and post -auricular areas,with intense local pain and tenderness.
.High fever
.chills
.marked systemic toxicity
.the infection is usually unilateral, bilateral infections are the more association,massive swelling of the neck and respiratory obstruction may occur.
.Other late manifestation include septic anemia , osteomyelitis of adjacent bones and organ failure.Diagnosis evaluations :-
Cultures may be obtained from parotid needle aspiration.
. ultrasound demon strates solid masses or fluid collection with in gland ,and detects hypoechoid areas.
. CT scanning and MRI with the gasolinium enhancement may be be used to determine the size and shape and presence of the neoplasm or abscess with in the gland.
Compliance,:-
.Prognosis :good/treatments for most salivary gland infection will go away on their own or are cured with treatment compliances are not common.
. possible complications: infection recurs ,abscess of salivary gland ,spread of infection cellulites ,ludwig’s angina.Finding:-
Subject:-oral or facial pain , especially when eating,
Abnormal four tastes ,dry mouth ,fever may be present .
Object:-v .facial a symmetry ,caused by unilateral parotid gland swelling.
. palpation reveals that the swelling is tender and indurated and follows the anatomical contour of the parotid gland.
.erythema ovee skin overlying the glands.
.intraorally ,a flow of saliva mixed with pus will be seen .
.interorally ,a flow of saliva mixed with pus will be seen exiting from the involved parotid duct orifice when the gland is forcefully massaged.Mangment:-
-adequate hydration.
-antimicrobial therapy.
-antibiotics should be administered intravenously include antihista phyloccal antibiotics (nafcillin ,oxacillin,cefezolin)
Cefoxitin ,imipenem,ertapenem, the combination of a penicillin plus -beta -lactamase.
(Amoxicillin/clavulanate ,am i cill in /sul bactam )
Vanomycin ,linezolid or daptomycin ,inpencillin allergic patients,clindamy in is an alternative options.Surgical management:-
.Surgical drainage and decompression of the gland are occasionally required if spontanous drainage does not occur.
. parotidectomy may eventually be required for people when long -standing infection.

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