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Swelling of Parotid Gland
Leo Leonidas MD, FAAP
Why Have a List of Differential Diagnosis?
It is important for clinicians to frequently refer to a list of differential diagnosis so they could ask good questions from the patient or parent. A list of different causes of diseases will also help reduce errors in diagnosis. Most clinicians who rely primarily on their memory do not have more than five to seven differential diagnoses in one clinical encounter. Although most illness in children are straightforward like ear infection, sinusitis, or throat infections, there are symptoms like joint pain or chronic belly pains that has a long lists of causes. With the use of Hand Held computers and other Devices, clinicians are making brilliant diagnosis that translates to better health care.
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CAUSES OF PAROTID GLAND SWELLING
The parotid gland (salivary gland) normally is not palpable nor “visible.” When this is enlarged it is commonly from a viral infection mumps. There are many more causes that can make the parotid gland swell. Here are some of them.
INFECTIONS AND INFLAMMATIONS
Mumps
Parinfluenza types 1 and 3
Other virus like Coxsackie A, Echonovirus, Varicella, CMV
Bacterial infections from Staphylococcus & H. Influenzae
Cat Scratch Disease
Tuberculosis
Actinomycosis
Sarcoidosis
Tularemia
Histoplasmosis
CHRONIC OR RECURRENT SIALADENITIS
Benign Lymphoepithelial Lesion
Idiopathic Causes
Functional Hypersecretion
Allergic Reactions
Drug Sensitivities
TUMORS
Mucoepidermoid tumor
Mixed Tumor
Lymphangioma
Hemangioma
METABOLIC AND ENDOCRINE DISORDERS
Hypothyroidism
Cushing Syndrome
Diabetes Mellitus
Starvation
Anorexia Nervosa
Postnecrotic Cirrhosis
OBSTRUCTIVE ENLARGEMENT
Strictures
Calculi
“WIND PAROTITIS” (From blowing up balloons or playing wind instrument)
OTHER CAUSES
Cystic Fibrosis
Sjogren Syndrome
Mixed Connective Tissue Disease
Systemic Lupus Erytematosus
Impaction of Stensen's Duct with Food Particles
Acquired Immune Deficiency Syndrome
DISORDERS THAT MIMIC PAROTID SWELLING
Lymphadenopathy
Masseter Muscle Hyperthrophy
REFERENCE:
Signs & Symptoms In Pediatrics
2nd Edition, page 144
Tunnessen, Jr
Belly Pain Air Leaks From Lungs Acute Crying Back Pain Bed Wetting Big Lymph Node Big Spleen Blood in Urine Chronic Diarrhea Chest Pain Cough Coughing Up Blood Constipation Droopy Eye Enlarged Glands Eye Swelling Excessive Thrist Facial Paralysis Fainting Spell Feeding Problem GI Bleeding Headache Head Tilt Hives High ESR Hoarseness Joint Pain Limp Leg Pain Muscle Weakness Noisy Breathing Nose Bleeding Nose Obstruction Pyuria Recurrent Infection Red Green Urine Ringing in the Ears Scrotal Swelling Seizures Stiff Neck Swelling of the Parotic Gland Toe Walking Toeing In Toeing Out Unequal Pupils Vomiting Wheezing
Leo Leonidas, MD, FAAP
Assistant Clinical Professor in Pediatrics
Tufts University School of Medicine, Boston
Attending Pediatrician
Eastern Maine Medical Center, Bangor
BANGOR, MAINE: “First City with EBPP (Evidence Based Pediatrics for Parents) Website
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