Parotitis (Mumps)

Parotitis is an inflammation of one or both parotid glands. There are a number of causes, but the clinical picture remains broadly similar.

Acute bacterial parotitis
This is an acute inflammatory response to bacterial infection which causes erythema (redness), pain, swelling and tenderness over the gland on the side of the cheek along with the appearance of pus from the opening of the duct on the inside of the cheek.

Treatment comprises correction of the lack of fluids (rehydration), antibiotics and pain relief.

Chronic recurrent parotitis
This refers to repeated episodes of discomfort and swelling of the parotid gland often after eating. It is caused by decreased flow of saliva often secondary to either blockage of the duct by a stone or the formation of a duct stricture (narrowing).

It is treated conservatively with gland massage, methods to stimulate the flow of saliva, lemon juice, and antibiotics if required. Surgery to remove the gland is possible but its benefits need to be balanced against the risk of damage to the facial nerve (which allows the muscles of facial expression to function).

Damage to the facial nerve can cause paralysis of one side of the face. X-ray treatment (radiotherapy) and treatment with steroid tablets have been described but are felt generally to be ineffective.