PAROTITIS

The parotid glands are the saliva-producing glands buried within each cheek.
Parotitis is an inflammation of the parotid salivary gland: it can be acute, or chronic with acute exacerbations. The parotid gland is the salivary gland most commonly affected by inflammation.

There are a number of causes, but the clinical picture remains broadly similar.

Cause-

1. Viral parotitis is more common than bacterial parotitis and mumps is the most common viral cause of parotitis.
2. Bacteria causing acute bacterial parotitis include:

• Staphylococcus aureus (historically the most common isolate).

More recent studies have shown mixtures of species, such as:

• Alpha-hemolytic Streptococcus spp.
• Hemophilus spp.
• Eikenella corrodens
• Prevotella spp.
• Strictly anaerobic Gram-positive cocci.

Less common pathogens (seen in hospitalized patients, those who have received previous antibiotic therapy and in the immunocompromised):

• Enterobacteriae
• Other Gram-negative bacilli
• Anaerobes.

3. TB is a rare cause of parotitis.
4. Candida infection can be seen in hospitalized or institutionalized patients with poor mouth care, but is uncommon.
5. In chronic parotitis, infection with Staphylococcus spp. or mixed infection with oral aerobes and anaerobes is common.
6. Autoimmune causes as in Sjögren's syndrome, Mikulicz disease and Lymphoepithelial lesion of Godwin.
7. Blockage-Blockage of the main parotid duct, or one of its branches. The blockage may be from a salivary stone, a mucous plug, or, more rarely, by a tumor, usually benign.

Viral parotitis (mumps) occurs most frequently in children. Parotitis that accompanies systemic diseases (eg, rheumatoid arthritis or HIV) mirrors the occurrence of those diseases.

Symptoms-

Parotitis symptoms usually refers to various symptoms known to a patient, but the phrase Parotitis signs may refer to these signs:-

• Swollen parotid glands- it may be unilateral or bilateral.
• Swollen glands near jaw and cheek
• face pain swelling of the parotid glands
• chewing aggravates the pain
• Restricted jaw movement
• fever
• headache
• anorexia
• moderate malaise
• sore throat
• swelling of the temples or jaw
• esticle lump
• scrotal swelling

In some chronic cases, non tender swelling of parotid gland appears.

Investigations-

1. Aspiration of pus from duct avoiding contact with oral mucosa to determining the causative organism.
2. Ultrasound or sialography- it is used to demonstrate the anatomy of the drainage system and is a very useful test.
3. CT-scan

Complications-

1. Orchitis.
2. Oophoritis.
3. Myocarditis.
4. Mastitis.
5. Acute pancretitis.
6. Otitis media.
7. Labyrinthitis.
8. Meningitis.
9. Peripheral neuritis.
10. Prostatitis.
11. Neuritis of II, VII, VIII, and III cranial nerves.

Treatment-

1. In some cases, no treatment is necessary.
2. If there is pus or a fever, or if the infection is known or thought to be bacterial, medications may be prescribed.
3. If there is an abscess, surgical drainage or aspiration may be done.
4. Good oral hygiene, with thorough tooth brushing and flossing at least twice a day may aid healing and help prevent an infection from spreading. Smoking prevents recovery.
5. Warm salt water rinses (1/2 teaspoon of salt in one cup of water) may be soothing and keep the mouth moist.
6. Drink lots of water and use sugar-free lemon drops to increase the flow of saliva and reduce swelling. Massaging the gland with heat may help.

Role of homoeopathy

There is a miraculously rapid cure in Homeopathy for most of the Acute Diseases especially those of viral origin, including parotitis. Homeopathy has proved to be of use in serious epidemics or pandemics. It is routinely used and prescribed for the prevention and as treatment with an effectiveness that has been recorded in several scientific publications. The medicine is selected on the basis of holistic approach. The whole organism is taken into consideration while prescribing medicine on the basis of the law of similars.

Please E-mail dr_ramanand@rediffmail.com for any questions/treatment