From the Guidelines
Most cases of acute parotitis do not require hospital admission and can be managed on an outpatient basis with supportive care. Hospital admission should be considered only for severe cases with complications such as dehydration, airway compromise, abscess formation, or in immunocompromised patients. When it comes to laboratory testing for mumps, it is recommended in suspected cases, particularly during outbreaks or in unvaccinated individuals, as stated in the guidelines by the Association of British Neurologists and British Infection Association 1. This typically includes viral culture or PCR from a parotid gland duct swab, taken after massaging the parotid gland for 30 s, or buccal (saliva) swabs, which are useful for the diagnosis of recent mumps virus infection, within 9 days of the onset of symptoms 1. Some key points to consider in the management of acute parotitis include:
- Laboratory testing for mumps to confirm the diagnosis and guide public health responses
- Supportive measures such as adequate hydration, analgesics like acetaminophen or ibuprofen for pain and fever, warm or cold compresses to the parotid area, and soft foods to minimize chewing discomfort
- Avoiding acidic foods and maintaining good oral hygiene
- Considering hospital admission for severe cases or those with complications
- Most viral parotitis cases resolve within 7-10 days without specific antiviral therapy, though bacterial parotitis may require antibiotics.
From the Research
Hospital Admission for Acute Parotitis
- Acute parotitis may require hospital admission, especially if the patient has severe symptoms or if the infection is caused by a bacterial pathogen that requires intravenous antibiotics 2, 3.
- A study found that factors such as patient age, C reactive protein, white cell count, blood urea nitrogen to creatinine ratio, and platelet levels at discharge were correlated with length of hospitalization, but only dehydration was found to be a statistically significant factor on multivariate analysis 3.
Laboratory Testing for Mumps
- Mumps virus is a common cause of parotitis, but other causes need to be distinguished from mumps through clinical presentations and ancillary tests 4.
- Viral parotitis can be caused by paramyxovirus (mumps), Epstein-Barr virus, coxsackievirus, and influenza A and parainfluenza viruses, and laboratory testing may be necessary to determine the cause of parotitis 5.
- However, the decision to send lab tests for mumps should be based on the patient's clinical presentation and medical history, and not all cases of parotitis require laboratory testing for mumps 4, 5.