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Parotitis

What Is It?
Symptoms
Diagnosis
Expected Duration
Prevention
Treatment
When To Call a Professional
Prognosis

What Is It?
Parotitis is an inflammation of the parotid glands. These are two large salivary glands. You have one in front of and just below each ear.

Either one or both parotid glands can be inflamed. They can be inflamed for several reasons, including:

  • Bacterial infection —This is more common in older people. Older people often take medicines that cause dry mouth. They also are more likely to be dehydrated. When your flow of saliva is reduced, bacteria can collect and grow in the tube that takes saliva from the parotid gland to the mouth.

  • A salivary stone in the parotid glands — The stone blocks the flow of saliva. This can lead to a swollen gland and sometimes an infection.

  • Mucus plugs — The parotid glands make saliva with mucus. When the mouth is dry, the mucus thickens and can block or slow the flow of saliva, causing parotitis.

  • Sjögren's syndrome — This is a lifelong disease that affects the salivary glands and the eyes.

  • Viral infections — Mumps used to be the most common viral infection of the parotid glands. However, it is rare today because of vaccinations.

  • AIDS — About 5 of every 100 people with HIV/AIDS have parotid gland problems.

  • A tumor — A tumor can block the flow of saliva and lead to parotitis. Usually, these tumors are not cancerous.

  • Certain medical conditions — Some conditions, such as diabetes, alcoholism and bulimia, can cause problems with the parotid glands. But they usually do not cause infection.

When air gets into the ducts of the parotid gland, it's called pneumoparotitis. This condition may or may not include inflammation. It most commonly occurs in wind instrument players, glass blowers and scuba divers.

Symptoms
The symptoms depend on the cause of the parotitis. Symptoms can include swelling, pain, bad taste and dry mouth.

Diagnosis
If the gland is tender and sore and the skin over it is red and warm, the gland is probably infected. Your doctor may remove fluid from the gland and send it to be tested. This can determine what caused the infection.

If you have mumps, your doctor can diagnose it based on your symptoms and medical history. Sometimes blood tests are helpful.

Your doctor may take an X-ray if he or she thinks you have a salivary stone. In some cases, a computed tomography (CT) or magnetic resonance imaging (MRI) scan also may help.

Expected Duration
Bacterial parotitis usually responds to antibiotics in a few days. But don't stop taking the medicine just because you feel better. Take it for as long as your doctor has ordered, usually one to two weeks. If you stop the medicine too soon, the infection may not be cured and may come back.

Mumps disappears on its own in about 10 days. Parotitis related to HIV/AIDS or Sjögren's syndrome can be managed, but it may never disappear. Parotitis related to other conditions (such as alcoholism or bulimia) may get better if the condition is brought under control.

Parotitis from a salivary stone or tumor should get better after the stone or tumor is taken out.

Prevention
Some people may be more likely to form salivary stones or mucus plugs. You can prevent stones and plugs by drinking plenty of fluids. You also can make more saliva by sucking on sour, sugarless candies. (Eating a large number of sugarless candies can cause diarrhea.) Your physician or dentist can show you how to massage your parotid glands to keep saliva flowing.

Treatment
If you have a bacterial infection, you most likely will be given antibiotics.

If you have mumps, treatment is not necessary. The condition will go away on its own. You should avoid contact with other people (stay isolated) for 7 to 10 days from when you first get mumps so other people do not get infected.

Small salivary stones can be taken out with a probe. You may need surgery to remove larger stones. Some stones can be flushed out or pulled out with tweezers. Some people have many salivary stones. They may need to have a parotid gland removed to solve the problem. Sometimes, mucus plugs can be washed away by making more saliva. To do this, drink plenty of liquids and suck on sour, sugarless candies. Sometimes massaging the gland can help.

People with Sjögren's syndrome can take medicines to increase the amount of saliva they have. One medicine is called pilocarpine (Salagen).

In people with AIDS-related parotitis, anti-HIV and other medicines may help.

When To Call a Professional
Call your doctor or dentist if you have enlarged or painful parotid glands.

Prognosis
In the long term, most cases of parotitis go away and don't return. Parotitis that is linked to another medical condition (such as HIV/AIDS or Sjögren's syndrome) may not go away completely. It also may go away, but keep coming back.

©2002-2013 Aetna, Inc. All rights reserved.

10/08/2013

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