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inflammation of one or both parotid glands

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/08/06 09:20:12」(JST)

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Parotitis is an inflammation of one or both parotid glands, the major salivary glands located on either side of the face, in humans. The parotid gland is the salivary gland most commonly affected by inflammation.

Causes

Infectious parotitis

Acute bacterial parotitis: is most often caused by a bacterial infection of Staphylococcus aureus but may be caused by any commensal bacteria.^[1]

Parotitis as Extrapulmonary Tuberculosis: The mycobacterium that cause tuberculosis can also cause parotid infection. Those infected tend to have enlarged, nontender, but moderately painful glands. The diagnosis is made by typical chest radiograph findings, cultures, or histologic diagnosis after the gland has been removed. When diagnosed and treated with antitubercular medications, the gland may return to normal in 1–3 months.^[1]

Acute viral parotitis (mumps): The most common viral cause of parotitis is mumps. Routine vaccinations have dropped the incidence of mumps to a very low level. Mumps resolves on its own in about ten days.

HIV parotitis: Generalized lymphadenopathy has long been associated with HIV, but the localized enlargement of the parotid gland is less well known^{[citation needed]}.

Autoimmune causes

These are also collectively known as chronic punctate parotitis or chronic autoimmune parotitis.

Sjögren's syndrome: Chronic inflammation of the salivary glands may also be an autoimmune disease known as Sjögren's syndrome. The disease most commonly appears in people aged 40–60 years, but it may affect small children. In Sjögren syndrome, the prevalence of parotitis in women versus men is approximately 9:1. The involved parotid gland is enlarged and tender at times. The cause is unknown. The syndrome is often characterized by excessive dryness in the eyes, mouth, nose, vagina, and skin.^[1]

Mikulicz disease: Antiquated name for any enlargement of the parotid gland that was not tuberculosis, leukemia, or some other identifiable disease.

Lymphoepithelial lesion of Godwin: Most frequently associated with a circumscribed tumor with the histologic features of Sjögren syndrome. This designation has also fallen out of favour.

Blockage

Blockage of the main parotid duct, or one of its branches, is often a primary cause of acute parotitis, with further inflammation secondary to bacterial superinfection. The blockage may be from a salivary stone, a mucous plug, or, more rarely, by a tumor, usually benign. Salivary stones (also called sialolithiasis, or salivary duct calculus) are mainly made of calcium, but do not indicate any kind of calcium disorder.^[2] Stones may be diagnosed via X-ray (with a success rate of about 80%^[2]), a computed tomography (CT) scan or Medical ultrasonography. Stones may be removed by manipulation in the doctor's office, or, in the worst cases, by surgery. Lithotripsy, also known as "shock wave" treatment, is best known for its use breaking up kidney stones. Lithotripsy can now be used on salivary stones as well. Ultrasound waves break up the stones, and the fragments flush out of the salivary duct.^[2]

Diseases of uncertain etiology

Chronic nonspecific parotitis: This term is generally used for patients in whom no definite etiology is found. Episodes may last for several days, paralleling the time course of a bacterial or viral illness. Others may experience episodes that last only a few hours from onset to resolution. Some episodes may last for several weeks. Quiescent periods between episodes last for hours, days, or even years.^[1]

Recurrent parotitis of childhood: An uncommon syndrome in which recurring episodes clinically resembling mumps. Generally, episodes begin by age 5 years, and virtually all patients become asymptomatic by age 10–15 years. The duration of attacks averages 3–7 days but may last 2–3 weeks in some individuals. The spectrum varies from mild and infrequent attacks to episodes so frequent that they prevent regular school attendance. Local heat applied to the gland, massaging the gland from back to front, and taking penicillin usually cure individual episodes. Treatment of individual infections may prevent injury to the gland parenchyma. Severe disease may be treated by parotidectomy.^[1]

Sialadenosis (sialosis): In this disorder, both parotid glands may be diffusely enlarged with only modest symptoms. Patients are aged 20–60 years at onset, and the sexes are equally involved. The glands are soft and non-tender. Approximately half of the patients have endocrine disorders such as diabetes, nutritional disorders such as pellagra or kwashiorkor, or have taken drugs such as guanethidine, thioridazine, or isoprenaline.

Sarcoidosis: The lungs, skin, and lymph nodes are most often affected, but the salivary glands are involved in approximately 10% of cases. Bilateral firm, smooth, and non-tender parotid enlargement is classic. Xerostomia occasionally occurs. The Heerfordt-Waldenstrom syndrome consists of sarcoidosis with parotid enlargement, fever, anterior uveitis, and facial nerve palsy.^[1]

Pneumoparotitis: Air within the ducts of the parotid gland with or without inflammation. The duct orifice normally functions as a valve to prevent air from entering the gland from a pressurized oral cavity. Rarely, an incompetent valve allows insufflation of air into the duct system. Pneumoparotitis most commonly occurs in wind instrument players, glass blowers, and scuba divers.^[1]

Several lymph nodes reside within the parotid gland as a superficial and deep group of nodes. These nodes may be involved with any process that affects lymph nodes, including bacterial, fungal, viral, and neoplastic processes. Rarely, drugs such as iodides, phenylbutazone, thiouracil, isoproterenol, heavy metals, sulfisoxazole, and phenothiazines cause parotid swelling.

Notes

^ ^a ^b ^c ^d ^e ^f ^g [1] Templer JW , MD, Professor of Otolaryngology, University of Missouri Medical Center at Columbia. Parotitis: Overview, Accessed 03/04/2009
^ ^a ^b ^c Salivary Gland Stones (Salivary Calculi) Accessed March 20, 2008.

References

Brook I. Acute bacterial suppurative parotitis: microbiology and management. [Journal Article] Journal of Craniofacial Surgery. 14(1):37-40, 2003.
Mandel L. Surattanont F. Bilateral parotid swelling: a review. [Review] [160 refs] [Journal Article. Review] Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontics. 93(3):221-37, 2002.

External links

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UpToDate Contents

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1. 成人における化膿性耳下腺炎 suppurative parotitis in adults
2. ムンプスの疫学、臨床症状、診断およびマネージメント epidemiology clinical manifestations diagnosis and management of mumps
3. 唾石症 salivary gland stones
4. 深頸部の感染症 deep neck space infections
5. 小児における耳痛の評価 evaluation of earache in children

English Journal

Sialendoscopy-Assisted Treatment for Chronic Obstructive Parotitis-Our Treatment Strategy with 31 Patients.

Wu CB1, Xue L2, Zhang B2, Sun NN2, Zhou Q3.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.J Oral Maxillofac Surg.2015 Aug;73(8):1524-31. doi: 10.1016/j.joms.2015.02.024. Epub 2015 Mar 12.
PURPOSE: Chronic obstructive parotitis (COP) is the most common non-neoplastic salivary disorder. The aim of this study was to describe the authors' experience using sialendoscopy for diagnosing and treating COP.MATERIALS AND METHODS: Thirty-one patients with COP who were treated with sialendoscopy
PMID 25970512

Clinical, epidemiological and etiological studies of adult aseptic meningitis: Report of 13 cases with mumps meningitis.

Takeshima S1, Yoshimoto T, Shiga Y, Kanaya Y, Neshige S, Himeno T, Kono R, Takamatsu K, Shimoe Y, Kuriyama M.
Rinsho shinkeigaku = Clinical neurology.Rinsho Shinkeigaku.2015 Jul 7. [Epub ahead of print]
We experienced 13 cases (29.8 ± 7.0 years) of mumps meningitis and 365 cases of adult aseptic meningitis during 11 years from 2004 to 2014. A small epidemic of mumps occurred for 3-4 years, and the incidence rate of adult mumps meningitis coincided with the epidemic without seasonal fluctuation. Pa
PMID 26156258

[Dermo-hypodermitis caused by group B Streptococcus in infants under 3 months of age: A retrospective study in two hospitals].

Tarbé de Saint Hardouin AL1, Mariani P2, Esteve V3, Msélati JC4, Lorrot M5, Blachier A6, Aujard Y7, Bonacorsi S8, Faye A5.
Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie.Arch Pediatr.2015 Jul;22(7):693-8. doi: 10.1016/j.arcped.2015.04.012. Epub 2015 May 26.
BACKGROUND: Very few studies describe group B streptococcal dermo-hypodermitis in newborns.OBJECTIVES: To describe the incidence, clinical characteristics, and course of group B streptococcal dermo-hypodermitis in infants less than 3 months old.PATIENTS AND METHODS: Infants under 3 months of age
PMID 26021451

Japanese Journal

流行性耳下腺炎を伴わないがムンプスウイルスの関与が疑われた劇症角膜内皮炎の1例 (特集第66回日本臨床眼科学会講演集(5))

川口亜佐子,武信二三枝,魚谷瞳 [他]
臨床眼科 67(7), 1143-1147, 2013-07
NAID 40019730902

Infantile Fibromatosis in the Parotid Gland: A Case Report

青井二郎,小森正博,西窪加緒里,兵頭政光
耳鼻咽喉科臨床 105(1), 41-46, 2012
… A one year and 9 months boy was referred to us for diagnosis and surgical treatments because a right parotid mass had continued to grow for two weeks even though he was taking an antibiotic for what was diagnosed as acute parotitis. …
NAID 130002141403

感染管理支援システムを用いた病院職員のウイルス抗体価およびワクチン接種歴情報管理

土屋憲,池ヶ谷佳寿子,明貝路子 [他],小路毅,増田昌文
日本環境感染学会誌 = Japanese journal of environmental infections 26(5), 311-315, 2011-09-26
2007年の国内での麻疹の流行に伴い，当院でも病院職員を対象とした麻疹，風疹，水痘および流行性耳下腺炎に対するウイルス抗体価の測定とワクチン接種を開始した．しかし，職員属性情報と抗体価測定データの管理の多くを手作業で行うため担当者の負担は大きく，効率性と正確性に問題があった．2010年，感染管理支援システムの導入に伴い，このような問題点を解消するためにワクチン接種歴の管理を加え職員感染管理のシ …
NAID 10030237051