Differentiating parotitis from other diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.

Overview

Parotitis must be differentiated from other diseases that present edematous swelling in the throat and neck. Diseases include retropharyngeal abscess, angioneurotic edema, salivary gland neoplasia, sjögren syndrome, and sialolithiasis and sialadenitis of the submandibular glands.

Differentiating Parotitis from Other Diseases

Parotitis must be differentiated from the following diseases:

Disease Findings
Retropharyngeal abscess Presents with neck pain, stiff neck, torticollis and may include enlarged cervical lymph nodes, fever, malaise, stridor, and barking cough. Requires tonsillectomy and use of antibiotics.[1]
Angioneurotic edema Presents with swelling of the dermis, subcutaneous, mucosa and submucosal tissues. Can occur in the upper respiratory system and result in stridor and respiratory arrest, requiring emergency treatment. Acquired angioneurotic edema results from an allergic reaction and be treated with epinephrine.[2]
Salivary gland neoplasia Swelling of the area proximal to the parotid gland can be the result of a salivary gland neoplasm. Usually presents itself with a painless mass and swelling in the gland. The various different salivary gland neoplasia can also present with fluid draining from the ear, pain, numbness, weakness, difficulty swallowing, and facial nerve palsy. Treatment and prognosis will vary depending on classification of the neoplasm.[3]
Sjögren's syndrome Presents swollen glands that must be differentiated from parotitis. It differentiates from parotitis in its presentation of eye itching and dryness, hoarseness, difficulty swallowing, loss of taste, difficulty speaking, teeth decay, and gum inflammation.[4]
Sialolithiasis and sialadenitis of the submandibular glands Presents with similar symptoms to sialolthiasis and sialadenitis of the parotid gland, including gland swelling, pain, tenderness, lack of saliva, low-grade fever, malaise, erythema. Treatment requires surgical removal of the salivary gland stone, NSAIDS for pain management and lowering [[inflammation] response, and potentially antibiotics in the event of bacterial infection.[5]

References

  1. Craig FW, Schunk JE (2003). "Retropharyngeal abscess in children: clinical presentation, utility of imaging, and current management". Pediatrics. 111 (6 Pt 1): 1394–8. PMID 12777558.
  2. Cicardi M, Zanichelli A (2010). "Acquired angioedema". Allergy Asthma Clin Immunol. 6 (1): 14. doi:10.1186/1710-1492-6-14. PMC 2925362. PMID 20667117.
  3. Speight PM, Barrett AW (2002). "Salivary gland tumours". Oral Dis. 8 (5): 229–40. PMID 12363107.
  4. "Sjögren syndrome: MedlinePlus Medical Encyclopedia".
  5. Rice DH (1984). "Advances in diagnosis and management of salivary gland diseases". West. J. Med. 140 (2): 238–49. PMC 1021605. PMID 6328773.

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