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Viral etiology of parotitis.

Viral etiology of clinically typical parotitis was studied by virus isolation and serology in 100 consecutive patients presented at the Department of Infectious Diseases, University of Turku, during a period of over 2 years. Mumps etiology was confirmed in 95 cases and in one case a probable parainfluenza type 3 infection was diagnosed by IgM serology. In the remaining 4 patients no etiological evidence of any of the viruses studied was obtained. When different methods to diagnose an acute mumps infection were compared, the most sensitive was the assay for specific IgM antibodies.

Adolescent↗

Bilateral suppurative parotitis in a newborn.

Suppuration occurring in inflamed parotid glands is an uncommon observation in the neonatal age group. This case report describes a male neonate, 12 days of age, who presented with high grade fever, irritability, poor feeding and bilateral swelling in the parotid region. Workup showed bilateral suppurative parotitis. Abscess developed despite antibiotic therapy requiring surgical drainage before final recovery.

Acute Disease↗

[Relapsing parotitis: onset of Sjögren's syndrome].

Report of a case of lymphocytic parotitis associated with important inflammatory syndrome, anti-salivary antibodies and rheumatoid factor. The study of the cases of literature suggests that it might be the mode of onset of a Sjögren's syndrome.

Antibody Formation↗

[Chronic obstructive parotitis: a report of 92 cases].

This article presents 92 cases (117 diseased parotid glands) of chronic obstructive parotitis with studies by clinical, sialographical, sequential quantitative scintigraphy methods and with investigation of the treatment. The nature of this disease is that various local factors cause obstruction of saliva flow resulting in recurrent swelling of parotid, in which the main feature in sialography is irregular dilatation of the main duct and branch duct. Sialographical manifestations can be divided into four types. Conservative, operative therapy and injection into diseased gland with 1% methyl violet are introduced to treat this disease. Long follow-up findings show that type I in sialography can be cured by conservative method, but other types to not respond to this method and should be treated by other methods, such as parotidectomy. We have used 1% methyl violet to treat cases who have swelling of parotid after conservative therapy. It is considered to be a simple, practical and good method and should only be used in this disease. There are no other side effects except swelling of parotid for a few weeks. Especially it can be used to treat the anterior part of main duct left over by parotidectomy, which still gives off purulent discharge.

Adolescent↗

[The clinico-morphological characteristics of the regional blood circulation of the parotid glands in patients with chronic parenchymatous parotitis].

Regional circulation in the parotid glands was studied in 34 patients with chronic parenchymatous parotitis (CPP) with the use of clinical (rheography and coagulography) and morphologic methods. A relationship has been revealed between regional circulation changes and the inflammation severity, CPP stage, type of concomitant diseases.

Adolescent↗

[On the ligation of Stenon's duct in chronic-recurrent parotitis (author's transl)].

Ligation of Stenon's duct represents a possibility for treatment of chronic-recurrent parotitis. This procedure leads to an atrophy of the gland parenchyma. In one case, observed by us as a complication of this method ligation of the duct was followed by the formation of a great parotid gland cyst. Under respect of this casuistic report, possibilities are discussed to prevent similar and other complications. They consist in the section of the preganglionic fibers of the tympanic plexus respectively in a simultaneous radiation therapy of the diseased gland.

Aged↗

Chronic parotitis.

Chronic parotitis is initiated when a salivary obstruction or decrease in salivary production leads to an inadequate ductal lavage. Such a condition favors a low-grade, ascending duct infection originating from the oral cavity. With the ensuing inevitable duct damage, repeated infectious flareups can be anticipated.

Adult↗

[The diagnostic value of magnetic resonance sialography for chronic obstructive parotitis].

PURPOSE: To evaluate the diagnostic value of magnetic resonance sialography (MRS) for chronic obstructive parotitis (COP). METHODS: 18 patients with COP underwent both conventional sialography and MRI sialography. A new magnetic resonance technique was applied. In addition to the usually performed T1 and T2 cross-sectional sequence, a heavy T2-weighted sequence (TR=4000 msec,TE=250 msec)was performed that allowed depiction of the fluid-filled parotid duct system. The MRI sialographic findings were compared with that of conventional sialography. The overall accuracy of diagnosis and ductal stenosis were assessed. RESULTS: The main duct of the parotid gland as well as primary branching ducts could be reliably depicted. Compared with the conventional sialography, the diagnostic accuracy of MRS was 94.4%(17/18) and stenosis diagnosis reached 100%(17/17). CONCLUSIONS: Initial experience indicates that magnetic resonance sialography can be applied successfully to investigate the duct system of the parotid gland. It is completely noninvasive and a promising alternative to radiographic sialography.

Adolescent↗

[Sialographic, sialoendoscopic and irrigation fluid study in chronic obstructive parotitis].

OBJECTIVE: To study the sialographic changes and to compare the changes with sialoendoscopic and irrigation fluid findings in chronic obstructive parotitis (COP). METHODS: This study involved 27 patients with a long history of parotid swelling. All patients were examined by X-ray, sialography, and were diagnosed as COP without sialolithiasis. Sialoendoscopy was used to observe the ductal system and irrigation treatment performed. The irrigated liquid was centrifuged and the deposits of fluid were stained and observed under microscopy. The sialographic changes were classified as previous studies and compared with sialoendoscopic and irrigation fluid findings. RESULTS: The sialographic changes of COP in 27 patients included 9 cases with type I, 5 cases with type II, 9 cases with type III and 3 cases with type IV changes, 1 case was normal. Marked obstructive factors such as stricture of ductal system were revealed in 21 cases on the sialogram. Sialoendoscopic examination showed that the ductal system was filled with fiber-like substances and hyperaemia of ductal wall in all cases. While few and thin fiber-like substances were found in the COP with sialographic type I and type II changes, many thick wadding or mass fiber-like substances were revealed in COP with sialographic type III and IV changes. Microstones were found in 2 COP with sialographic type III changes which were stained and identified by microscopy. Foreign body (drug bar) was found in one COP with sialographic type I changes with sialoendoscopy. Irrigation fluid examination showed fiber-like substance was composed of desquamative duct epithelial cells, neutrophil, lymphocytes, acidophile. Some epithelial cells were found in two microliths. CONCLUSIONS: The pathological basis of fiber-like substance on sialoendoscopy is desquamative duct epithelial cells. Fiber-like substance in the lumen of ductal system is considered as one of the obstructive factors in COP. Sialoendoscopic findings is related to sialographic changes.

Adult↗

[Suppurative bacterial acute parotitis in adults. Clinic and microbiological findings in 10 admitted patients].

We report the clinic and microbiological findings that were obtained in 10 adult patients admitted by our ENT Service with diagnosis of suppurative bacterial acute parotitis. S. aureus and Streptococcus sp were the most isolated organisms. All the patients were treated by hidratation, endovenous antibiotic therapy sometimes modified according to the antibiogram results, analgesics and antiinflammatories with success. In 3 times it was necessary to drain the purulent collection and in one of them there was a retroauricular abscess secondary to sialoadenitis.

Acute Disease↗

Acute transient parotitis after high dose etoposide and autologous bone marrow transplantation.

Etoposide is an important component of several intensive therapy regimens in allogeneic and autologous bone marrow transplantation for advanced hematologic malignancies. We observed the occurrence of transient acute parotid and submandibular sialoadenitis in nine of 19 patients receiving high dose etoposide and melphalan followed by autologous bone marrow rescue. Manifestations included pain, tenderness and swelling of the parotid and submandibular glands. Symptoms arose 4-16 h after completion of etoposide infusion and resolved within 72 h. Elevation of serum amylase accompanied the symptoms, and was also observed in some patients who were asymptomatic. Discomfort was controlled with analgesics and the clinical course was uncomplicated in all cases. Transient parotitis is a relatively frequent and benign complication of high dose etoposide therapy.

Acute Disease↗

[Purulent parotitis in an infant].

A sibling was taken into hospital at the age of 3 weeks with an acute suppurative parotitis of the left parotid. Since birth, the child had suffered from recurrent infections. Her mother was known with recurrent furunculosis. Ultrasonography of the left parotid showed a diffuse enlarged parotid with multiple areas of necrosis. After a diagnostic puncture, a penicillin resistant Staphylococcus aureus was found. Therapy consisted of intravenous antibiotics.

Female↗

[Recurrent parotitis in childhood (report of 102 cases)].

This article presents 102 cases of recurrent parotitis in childhood with studies of clinical findings, sialographic manifestations, dynamic functions of the parotid gland examined with radionuclide, laboratory findings and follow-up studies of 28 cases including sialography. The following conclusions are reached: 1. The etiology is retrograde infection induced by mumps virus and upper respiratory infection which lower the resistance of the child. Familial abnormalities are potential factors. Incomplete immune function of the children is also a factor related to pathogenesis of this disease, and following growth and development of the immune system this disease will undergo remission. 2. This disease involves both parotid gland generally. 3. Sialographic manifestations will disappear following subsidence of clinical symptoms, but it may take years. 4. If the disease has not been cured in childhood, it may continue to adult and then healing will take place. Relationship with Sjögren's syndrome has not been revealed.

Adolescent↗

[Difficulties in the differential diagnosis of chronic interstitial parotitis and an acinar-cell tumor].

Clinical pictures of parotid tumors and chronic interstitial parotitis are similar to several extent. Cytologic investigation of punctate from the suspected tumor can have a crucial value for diagnosis. Additional thorough investigation in a special clinic using any available technique is expedient in cases of cytological detection of a rarely occurring tumor.

Cytodiagnosis↗

[Vestibular dysfunction and deafness complicating mumps parotitis].

A 9-year-old boy developed severe positional vertigo, unsteadiness, vomiting and nystagmus during active mumps parotitis. Audiometric examination showed complete right sensorineural hearing loss. Brain stem evoked response to audiometric stimulation of the left ear was normal, but was absent on stimulation of the right ear. CT scan of the brain was normal. While vestibular symptoms gradually improved during 1 week, the deafness on the right was permanent. Acute vestibulitis during mumps is very rare, but permanent unilateral deafness might be a much more common, severe, persistent complication than is generally believed. Such cases call for an urgent change in Israel's vaccination policy so that vaccination against mumps is included.

Audiometry↗