Viral parotitis
Background
- Acute infection of the parotid glands
- Most often caused by paramyxoviruses (e.g. mumps), but should consider influenza[1]; less commonly by parainfluenza, coxsackie, echo, HIV
- Most common in children <15yrs
- Contagious for 9 days after onset of parotid swelling
Complications
- Mastitis, pancreatitis, aseptic meningitis, hearing loss, myocarditis, polyarthritis, hemolytic anemia
Clinical Features
Differential Diagnosis
Bilateral Parotitis
- Viral infections
- Viral parotitis
- Parainfluenza
- Coxsackie virus
- influenza A
- Epstein-Barr virus
- Adenovirus
- HIV
- Cytomegalovirus
- Bacterial infections
- Noninfectious
- Salivary calculi
- Tumors
- Sarcoidosis
- Sjögren’s syndrome
- Thiazide diuretics
Evaluation
- Generally a clinical diagnosis
- May confirm diagnosis with mumps immunoglobulin (IgM and IgG) or PCR (may also be needed by local health department for reporting)
- Testicular ultrasound if concern for orchitis
- [[Lumbar puncture if concern for associated meningitis/encephalitis
Management
- Supportive care is the mainstay of treatment
Disposition
- Isolated parotitis or orchitis: manage as outpatient
- Systemic complications: admit
- Report to local health department (nationally reportable disease)
External Links
Video
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References
- Rolfes, Melissa A, et al. “Influenza-Associated Parotitis During the 2014–2015 Influenza Season in the United States.” Clinical Infectious Diseases, vol. 67, no. 4, 2018, pp. 485–492., doi:10.1093/cid/ciy136.
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