From the Guidelines
Parotiditis, most commonly caused by the mumps virus, should be managed with symptom-focused treatment, including rest, hydration, and pain relievers like acetaminophen or ibuprofen, as there is no specific antiviral treatment available, as noted in studies such as 1. For viral parotiditis (mumps), the primary approach is supportive care. This includes:
- Rest to help the body recover
- Hydration to prevent dehydration
- Soft foods to reduce discomfort while eating
- Pain relievers like acetaminophen or ibuprofen (400-600mg every 6-8 hours) to manage pain and fever Bacterial parotiditis, on the other hand, requires antibiotic treatment, typically with amoxicillin-clavulanate (875/125mg twice daily for 7-10 days) or clindamycin (300-450mg four times daily) for patients allergic to penicillin. Additional measures to help manage parotiditis include:
- Applying warm compresses to the affected area for 15 minutes several times daily to reduce pain and swelling
- Maintaining good oral hygiene
- Increasing fluid intake to stimulate saliva production
- Avoiding acidic or spicy foods that may worsen pain It's crucial to monitor for worsening symptoms, such as high fever, increasing swelling, difficulty swallowing, or breathing problems, as these may indicate complications like abscess formation that require immediate medical attention and possibly surgical drainage, as suggested by the management principles outlined in 1. Prevention of mumps, a common cause of parotiditis, is effectively achieved through the MMR (measles, mumps, rubella) vaccine, typically administered in childhood, highlighting the importance of vaccination in preventing infectious diseases, as discussed in 1.
From the Research
Causes of Parotiditis
- Viral parotitis can be caused by paramyxovirus (mumps), Epstein-Barr virus, coxsackievirus, and influenza A and parainfluenza viruses 2
- Acute suppurative parotitis is generally caused by Staphylococcus aureus, Streptococcus species, and rarely, gram-negative bacteria 2
- Anaerobic bacteria, mostly Peptostreptococcus species and Bacteroides species, and pigmented Porphyromonas species and Prevotella species have been recognized as an important cause of this infection 2
Clinical Presentations and Management
- Mumps virus is the most common cause of parotitis, but other causes need to be distinguished from mumps 3
- Knowledge of the various clinical presentations of parotitis and judicious use of ancillary tests will facilitate differential diagnosis 3
- Chronic parotitis is an insidious inflammatory disorder, characterized by a recurrent, often painful, swelling of the gland or glands 4
Diagnosis and Treatment
- Sialography remains the investigation of choice for chronic parotitis 4
- Diagnostic siladenoscopy may complement or supersede sialography as the diagnostic procedure of choice 4
- Management options for chronic parotitis are conservative or surgical, but controversy exists regarding the timing and method of surgical intervention 4
- Treatment for chronic parotitis can be palliative in nature, and early clinical recognition leads to appropriate and successful care 5