Updated by Piper Wenzel, BS April 2024
- Uncommon and dangerous sequelae of parotitis (Scattergood 2018; Saibene 2022)
- Symptoms may include pain, fever, palpable swelling (Patra 2023)
- Predominant risk factor is poor oral hygiene and dental caries (Patra 2023)
- Other risk factors include immunosuppression, dehydration, and ductal dysfunction (Patra 2023)
- Most common bacteria involved is Staph aureus; others include Streptoccocus, Hemophilus, Pseudomonas, Mycobacterium tuberculosis, and anaeroic bacteria (Saibene 2022; Patra 2023)
- Has potential to spread to deep head and neck spaces and cause life-threatening fasciitis (Patra 2023)
- May require surgical incision and drainage if not responding to conservative treatment with antibiotics (Patra 2023; Scattergood 2018; Saibene 2022)
- A common first imaging modality is ultrasound for diagnosis and to guide incision and drainage (Patra 2023)
- On CT: look for hypodense fluid and wall-enhancement with associated fat stranding and surrounding edematous changes
- On MR: intermediate internal signal on T1 and high internal signal on T2 with enhancement post-contrast
References
Patra S, Das S, Tamuli P, Chakraborty S. Paediatric Parotid Abscess: A Rare Presentation. Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):4054-4056. doi: 10.1007/s12070-023-04030-7. Epub 2023 Jul 6. PMID: 37974835; PMCID: PMC10645870.
Scattergood S, Moore S, Prior A, Yusuf GT, Sidhu PS. Percutaneous drainage of a parotid gland abscess under contrast-enhanced ultrasound guidance: A case report. Ultrasound. 2018 Aug;26(3):182-186. doi: 10.1177/1742271X18766705. Epub 2018 Mar 27. PMID: 30147743; PMCID: PMC6099765.
Saibene AM, Allevi F, Ayad T, Lechien JR, Mayo-Yáñez M, Piersiala K, Chiesa-Estomba CM. Treatment for parotid abscess: a systematic review. Acta Otorhinolaryngol Ital. 2022 Apr;42(2):106-115. doi: 10.14639/0392-100X-N1837. PMID: 35612503; PMCID: PMC9132006.