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Viral Parotitis - Causes, Symptoms, Diagnosis, and Treatment

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Acute viral parotitis is a systemic infection localized to the parotid gland, leading to inflammation and swelling of the gland. Read the article below to know more about it.

Written by

Dr. Preetha. J

Medically reviewed by

Dr. Sneha Kannan

Published At March 1, 2022
Reviewed AtFebruary 21, 2023

What Are the Types of Salivary Glands?

The three major types of salivary glands are:

  • Parotid gland.

  • Submandibular.

  • Sublingual.

All three salivary glands are the most prominent salivary glands, with their duct. Salivary gland tumors occur very rarely. The parotid salivary gland, the largest among the three major salivary glands, is found in front of and below the ear. Salivary tumors usually occur in this gland.

The parotid gland has two parts or lobes, namely,

  • Superficial lobe.

  • Deep lobe.

The facial nerve is present between these two lobes. The facial nerve controls the ability to close the eyes, raise eyebrows, and smile. The other critical structures near the parotid salivary glands are:

  • The external carotid artery.

  • The retromandibular vein.

  • A branch of the jugular vein.

  • A major blood vessel that supplies the head and neck region.

Sublingual glands are present under the tongue on the floor of the mouth, and submandibular glands are found below the mandibular jawbone. It requires great precision because the surgeon has to locate and operate around these important structures.

What Is Parotitis?

The parotid glands are small exocrine glands located in front and around the ramus of the jaw. The parotid gland is rarely affected by diseases of any kind. Parotitis is the infection and inflammation in one of the salivary glands, namely the parotid gland. It can be acute or chronic. Parotitis is assumed to be caused by the ascending infection from the oral cavity. Based on the patient population, many risk factors are associated with acute parotitis, with dehydration being the most significant.

What Is Viral Parotitis?

The painful enlargement of the parotid gland occurs in children due to viral parotitis (mumps). The paramyxovirus disease, the mumps virus, is spread by droplets or direct contact. The prevalence of viral parotitis has been drastically decreased after the introduction of vaccination since the 1970s. Viral parotitis is commonly seen in underdeveloped countries.

What Are the Causes of Viral Parotitis?

Viral parotitis can be caused by:

Children have the highest risk of acquiring viral parotitis, which is decreased after introducing the mumps vaccine.

What Are the Symptoms of Viral Parotitis?

Viral parotitis can cause swelling in the parotid glands on both sides of the face, giving the appearance of chipmunk cheeks. About 30% to 40% of salivary gland infection is commonly associated with mumps. Viral parotitis is a contagious disease. Children with viral parotitis can typically start with a few days of fever, headache, muscle aches, dry cough, body pain, tiredness, loss of appetite, and swelling of their salivary glands (puffy cheeks and a tender and swollen jaw).

What Are the Risk Factors for Viral Parotitis?

The risk factors for viral parotitis are:

  • Cystic fibrosis.

  • Sjogren syndrome.

  • Contact with the person infected with mumps.

  • HIV or AIDS (human immunodeficiency virus or acquired immunodeficiency syndrome).

  • Poor oral hygiene.

  • Dehydration.

  • Not being vaccinated with the MMR (measles, mumps, and rubella)vaccine.

  • Certain medications such as antipsychotics, antihistamines, and anticholinergic.

Why Is It Essential to Know Whether the Viral Parotitis Is Due to Influenza or Mumps?

The viral parotitis caused by both mumps and influenza virus is contagious and can be transmitted. If a person has suspected mumps infection, the patient should be isolated and tested for mumps. If a suspected patient tested negative for mumps, it does not result in mumps as a diagnosis. But still, testing for alternative organisms, like influenza, should also be considered if influenza is circulating in the community. Mumps can be severe, but the majority of the people infected with mumps will recover completely within two weeks. The infected people may feel tired, have body pain, fever, and swelling in the salivary glands on the side of the face. Others may include feeling extremely ill and difficulty eating because of jaw pain, and a few may also develop serious complications.

What Is the Differential Diagnosis of Viral Parotitis?

Differential diagnosis of an enlarged parotid gland may include:

  • Acute bacterial parotitis.

  • HIV parotitis.

  • Parotitis related to tuberculosis.

  • Mikulicz disease.

  • Sialolithiasis.

  • Chronic recurrent parotitis.

  • Sarcoidosis.

  • Benign and malignant tumors.

  • Bilateral parotitis.

  • Viral infections.

  • Parainfluenza.

  • Coxsackievirus.

  • Influenza A.

  • Epstein-Barr virus.

  • Adenovirus.

  • Cytomegalovirus.

  • Bacterial infections like Staphylococcus aureus.

  • Salivary calculi.

  • Sjögren’s syndrome

  • Thiazide diuretics.

How to Diagnose Viral Parotitis?

The doctor will inquire about your symptoms and medical history if any. Followed by a physical examination of the parotid gland, which may be enough to make a diagnosis. Tests for viral parotitis may include a blood test and a fluid sample from the parotid gland. The other tests to be conducted are:

  • Mumps immunoglobulin (IgM and IgG) or PCR (polymerase chain reaction).

  • Testicular ultrasound if concerned for orchitis (inflammation of one or both the testicles).

  • Lumbar puncture to be done if associated with meningitis or encephalitis.

How to Treat Viral Parotitis?

There is no medical cure for mumps, but the MMR vaccine can prevent it. Treatment involves management of symptoms like:

  • Relieving pain.

  • Preventing dehydration.

  • Rest as much as possible.

  • Cold compress.

  • Over-the-counter pain relievers like Ibuprofen and Acetaminophen.

The immune system will work to clear the infection from the body.

How to Prevent Viral Parotitis?

Parotitis can be prevented by taking specific self-care tips:

  • Practice good oral hygiene.

  • Brushing the teeth at least twice a day.

  • Flossing the teeth daily to prevent and clear infections.

  • Rinsing the mouth with salt water regularly.

What Are the Complications of Viral Parotitis?

The complications of viral parotitis are:

  • Mastitis.

  • Pancreatitis.

  • Myocarditis.

  • Aseptic meningitis.

  • Polyarthritis.

  • Hearing loss.

  • Hemolytic anemia.

  • Osteomyelitis.

  • Lemierre syndrome.

  • Sepsis.

  • Organ failure.

  • Facial paralysis.

Frequently Asked Questions


Does Viral Parotitis Spread?

Parotitis is the inflammation of the parotid gland. Through droplets of saliva (spit), parotitis caused by a viral or bacterial infection can easily spread to others. Therefore, towels, eating utensils, cups, and other personal items should not be shared during infectious parotitis.


How to Differentiate Between Viral and Bacterial Parotitis?

In acute bacterial parotitis, the patient typically presents with gradual, painful gland swelling, which worsens when chewing. The symptoms of acute viral parotitis, also known as mumps, which is pain and swelling of the gland, range from five to nine days in duration. Anorexia, moderate malaise, and fever are present.


What Most Commonly Causes Parotitis?

The most common cause of parotitis includes infection due to viruses or bacteria. However, it can also be caused due to other conditions, including -
- Sialolithiasis (obstruction of the parotid gland ducts).
- Sjogren's syndrome (immune system disorder with characteristic dry eyes and dry mouth).
- Rheumatoid arthritis (autoimmune disorder affecting joints).
- Systemic lupus erythematosus (inflammatory and autoimmune disorder).
- Sarcoidosis (inflammatory cells growth in any body part).


Are Antibiotics Required for Parotitis?

In community-acquired cases of parotitis, the first line of treatment usually involves-
- First-generation cephalosporin (Cefazolin).
- Antistaphylococcal penicillin (Oxacillin and Nafcillin).
- Clindamycin and Vancomycin for suspected methicillin-resistant S. aureus.


How Long Does Parotitis Last?

The majority of cases of parotitis resolve after ten days, with an average duration of five days. Infection with the mumps may also only cause nonspecific or primarily respiratory symptoms. In some cases, however, it may be asymptomatic.


Who Might Get Parotitis?

Children between the ages of 2 and 12 who have not been immunized against the disease are most likely to develop parotitis. Be that as it may, the disease can happen at whatever stage in life and may likewise be found in college-age students. The incubation period, or time between exposure to the virus and illness, is approximately 12 to 25 days.


How to Treat Parotitis at Home?

To treat parotitis at home, below are some common remedies that one try-
- Rinsing the mouth with warm salt water to keep the mouth moist and ease the pain.
- Drinking lots of water and using sugar-free lemon drops increases saliva flow and reduces swelling.
- Stop smoking to speed up the healing.


Can COVID Be Associated With Parotitis?

Coronavirus disease (COVID) symptoms include respiratory and gastrointestinal problems and fever. Atypical manifestations of COVID-19 have been reported, despite the fact that the virus most commonly causes symptoms in the respiratory tract. In addition, it has been established that acute parotitis is a COVID-19-related clinical manifestation. To prevent disease transmission, clinicians must be familiar with these unusual presentations.


Which Virus Causes the Infection of Parotid Glands?

The mumps virus, a member of the paramyxoviruses family, is the cause of viral parotitis, also known as mumps. It is best known for swelling of the parotid glands, but it can infect many body parts. It is a very common infection known to recur in most cases.


Can Parotitis Cause Fever?

Mumps, also known as viral parotitis, is a contagious illness. It begins with mild symptoms like headache, fever, and tiredness. However, it typically results in severe parotitis, or swelling of some salivary glands, which causes a tender, swollen jaw and puffy cheeks.


How to Test for Parotitis?

The face will be visually examined by a healthcare professional. They might press lightly on the skin along the jawline and in front of the ears. The provider may also massage from the back to the front of the parotid gland to confirm a parotitis diagnosis. This helps them determine whether the saliva contains pus or drainage.


Can Parotitis Be Resolved on Its Own?

With treatment, people with parotitis typically have a favorable outlook. Usually, the condition lasts between seven and ten days. Most people fully recover without complications, even without treatment.


Is Parotitis Infection Cancerous?

Rapid swelling is more likely to indicate a malignant tumor or infection, while slow swelling typically indicates a benign tumor. Facial nerve palsy, or difficulty moving one side of the face, can indicate a malignant, advanced tumor, principally in the parotid gland.


What Does Parotitis Pain Feel Like?

Pain in the area of the gland that is swollen is one of the most common parotitis symptoms. The parotid glands of the majority of people with acute parotitis are extremely tender. Most of the time, people who have chronic parotitis do not feel much pain or discomfort. Other symptoms may include fever with chills, sore throat, headache, tiredness, and loss of appetite.
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Dr. Preetha. J
Dr. Preetha. J



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