OBJECTIVE: Determine the outcomes in children with recurrent sialadenitis after establishment of a multidisciplinary pediatric otolaryngology and rheumatology clinic.
METHODS: Retrospective review.
METHODS: Single-center tertiary medical center.
METHODS: We reviewed all children presenting to a multidisciplinary pediatric otolaryngology/rheumatology clinic with recurrent parotitis between December 2019 and April 2023.
RESULTS: Thirty-three children presented with recurrent parotitis to a multidisciplinary clinic. Seventy-seven percent of those with childhood Sjögren\'s disease (cSjD) had xerophthalmia, and 67% had xerostomia. The cSjD group was more likely to have both abnormal parotid and submandibular findings when compared to the non-cSjD group (P < .001). Sixteen percent of the cSjD group had a positive SSA/SSB autoantibody and 47% were antinuclear antibody positive. Fifty percent of the cSjD cohort had a focus score of ≥1 from a minor salivary gland biopsy. There were no significant differences from sialendoscopy outcome between the 2 groups. Seventy percent with juvenile recurrent parotitis showed partial response (PR) or complete response (CR) to sialendoscopy. In the cSjD cohort 3 (27%) reported a CR and 5 (45%) reported a PR. In the non csSjD cohort 5 (42%) reported a CR and 3 (25%) reported a PR. Ten of the 12 cSjD patients on hydroxychloroquine have shown symptom improvement.
CONCLUSIONS: The establishment of a multidisciplinary otolaryngology and rheumatology clinic can provide a more comprehensive evaluation and treatment of the child with recurrent or persistent parotitis than from a regular ENT clinic.

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BACKGROUND: Juvenile recurrent parotitis is a rare disease characterized by repeated episodes of inflammation affecting, unilaterally or bilaterally, the parotid glands during childhood.
METHODS: Retrospective study including patients diagnosed with juvenile recurrent parotitis between January 2010 and September 2020 at a tertiary level hospital, with the aim of evaluating the results of medical treatment and sialendoscopy.
RESULTS: A total of 48 patients met the inclusion criteria and had a mean follow-up of 4 years (SD = 3; Min: 2/Max: 12). Regarding treatment, 34 (70.8%) patients received conservative treatment and had a mean of 5 episodes (SD = 3; Min: 2/Max: 13) until symptom resolution. Meanwhile, 14 (29.2%) patients underwent sialendoscopy, of which two (12%) required reintervention. In 100% (14) of the patients treated with sialendoscopy, the findings were consistent with JRP and, after sialendoscopy, a statistically significant reduction in episodes was observed, with a mean of 1 post-intervention episode (SD = 1.5; Min:0/Max: 6) (P < .001).
CONCLUSIONS: The results obtained in this study suggest that sialendoscopy is a useful tool in the treatment of juvenile recurrent parotitis. However, new studies comparing the results of sialendoscopy with other therapeutic alternatives are necessary.

BACKGROUND: A parotid abscess (PA) is a complication of an acute bacterial parotitis with a potentially life-threatening course. To date, data on the diagnosis and therapy of PA is sparse and mostly consists of case reports or case series. Therefore, this study aimed at comprehensively analyzing the microbiological spectrum and the therapeutic management in a bi-institutional setting.
METHODS: A retrospective clinical chart review was performed to identify all patients surgically treated for PA at two tertiary care centers in Germany. Data on demographics, clinical management and microbiological data including species identification, pathogenicity, type of antibiotic therapy, adjustment of antibiotics, antibiotic sensitivity testing, and smear test results were extracted. Intervention-related variables and etiology were analyzed for their statistical association with outcome variables.
RESULTS: Overall, 85 patients were included. Most patients (92.9%) underwent surgical incision. Around half of the patients (45.9%) were treated under local anesthesia. No facial nerve palsy was observed. The most frequently detected pathogens were Streptococci (n = 23), followed by Staphylococcus aureus (n = 6) including one case of methicillin-resistant Staphylococcus aureus. Most patients (68.2%) received an aminopenicillin ± beta-lactamase inhibitor as empiric antibiotic therapy. In 6 cases the antibiotic therapy was modified after receiving the antibiogram. Four patients (5.2%) presented with recurrent PA. Etiology was idiopathic (42.4%), followed by tumorous (12.9%), obstructive, and immunosuppressive (each 11.8%). Patients with a dental focus (p = 0.007) had a longer duration of hospitalization.
CONCLUSIONS: The results show that the surgical therapy of PA under local anesthesia is safe. A dental examination should routinely be performed to rule out a dental focus. Obtaining a microbiological specimen in order to modify antibiotic therapy if necessary and a histopathological specimen to rule out a tumorous etiology is obligate.

Mild encephalitis/encephalopathy with reversible splenial lesion (MERS) is characterized by mild neurological manifestations associated with spontaneously reversible lesions of the splenium of the corpus callosum. While various conditions and diseases can trigger MERS, infectious causes predominate, with mumps being notably linked to MERS in the pediatric population. Although rare in adults, there are sporadic case reports associating mumps with MERS. Here we report a 23-year-old male patient with a typical presentation of mumps who presented with meningeal syndrome, dizziness, seizures, and right orchitis. Brain MRI showed classic findings of MERS syndrome while cerebrospinal fluid analysis demonstrated lymphocytic pleocytosis. Our patient had a confirmed diagnosis of mumps disease with multiple complications, including MERS, meningitis, and orchitis, and was managed with symptomatic medications and antiviral therapy. Subsequently, there was a gradual resolution of these manifestations and the outcome was favorable, with no residual sequelae.

Contrast material containing Iodine can cause parotitis. Here we present A 70 year\'s old man admitted to United Hospital Limited, Gulshan, Dhaka, Bangladesh on 5th May 2021 with the complaints of chest pain and shortness of breath and he was diagnosed as NSTEMI with ALVF. He was Covid 19 positive two weeks back. He underwent PCI to LM to LAD, LCX and RCA two years back. He had hypertension, diabetes mellitus and dyslipidemia. He was taking dual antiplatelet, beta-blocker, ACE inhibitor, statin, diuretic and anti-diabetic medication. His physical examination findings were reasonably normal. An electrocardiogram revealed bi-fascicular block and echocardiogram showed inferior wall and basal segment of inferior-lateral wall were hypokinetic. His high sensitive Troponin I was raised and serum creatinine was normal. This case report contains a case of bilateral parotitis following coronary angioplasty, subsided with conservative management. Possible reasons may be the direct toxicity or idiosyncratic reaction of the iodinated contrast agent.

Primary tuberculous parotitis is an extremely rare entity presenting with nonspecific symptoms, variable clinical signs, and imaging features mimicking parotid neoplasm. It is a clinical and diagnostic challenge, and a confirmed histological diagnosis would indicate nonoperative management, thus avoiding unwarranted surgery and associated morbidity. Tuberculosis of the salivary gland is a relatively rare extrapulmonary manifestation of tuberculosis, with the incidence of tuberculous parotitis being 2%-9%. The prevalence of disseminated tuberculosis has increased in recent times because of the use of immunosuppressive therapy for organ transplantation and chemotherapy. However, the incidence of concurrent pulmonary tuberculosis in patients with tuberculous parotitis is a rarer scenario. Fine-needle aspiration cytology (FNAC) can confirm the diagnosis of tuberculous parotitis with a high sensitivity (84%-100%) and specificity (94%-100%). The utility of FNAC is also enhanced as the aspirate can be utilized for cartridge-based nucleic acid amplification test (CBNAAT) testing for mycobacterium and drug sensitivity testing, thereby further increasing its sensitivity and specificity. This translates to a lesser chance of unnecessary surgical intervention and the potential surgical morbidity. Here, we report a case of parotid swelling in a 72-year-old male, with no evidence of any pulmonary or systemic tuberculosis, with clinical and imaging features suggestive of parotid neoplasm but diagnosed as tubercular parotitis on FNAC. He was started on antitubercular therapy, which resulted in the progressive diminution of the size of the lesion. Primary tuberculous parotitis should be considered a possibility while managing the parotid neoplasm.

Coronavirus disease 2019 (COVID-19) emerged in China at the end of 2019 and spread worldwide. A sixty-three-year-old female patient was admitted to the hospital six days after she tested positive for SARS-CoV-2 with complaints of cough, shortness of breath, and myalgia. After seven days, both parotid gland sites developed swelling, tenderness, and pain. The ultrasonography revealed acute parotitis bilaterally. Viral serological tests were negative. Therefore, COVID-19 infection was considered the cause of acute parotitis. The patient was discharged after recovery. This case report emphasized that acute non-suppurative parotitis may develop due to COVID-19 infection as an atypical manifestation.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection usually affects the respiratory system; however, a number of atypical manifestations of this disease have also been reported, especially in children. The present study reports a case of a 12-year-old presenting with right unilateral parotitis and sialadenitis and SARS-CoV-2 infection. The young patient, after a 3-day history of fever, was brought to our clinic (Polyclinic University Hospital \'G. Rodolico\', Catania, Italy) for the sudden onset of unilateral parotitis accompanied by sialadenitis and hyperaemia of the skin, which was tender to touch. The SARS-CoV-2 molecular swab was positive; the ultrasound of the affected region showed an increase in the volume of the parotid and sublingual gland and reactive lymph nodes compatible with parotitis and sialadenitis. This case suggests that, in the present Coronavirus disease 2019 pandemic, SARS-CoV-2 should be included in the differential diagnosis of parotitis and sialadenitis along with mumps and flue. Notably, a respiratory panel and serology for other potential causes are needed in case of parotitis-like disease.