Acute Parotiditis may be viral, when it is commonly secondary
to mumps infection, or bacterial in origin.
Viral salivary gland infections are the most common in children.
A particular predilection for the salivary glands is shown by
mumps virus and cytomegalovirus.
Acute bacterial infections are usually caused by Staphylococcus
aureus or oral flora and infection usually relates to sepsis of
adjacent structures, e.g. skin, ear, teeth, parotid calculi or
systemic disease causing immunosuppression.
In acute inflammation, the gland enlarges, appears hypoechoic
and of heterogeneous echotexture. They may be inhomogeneous; may
contain multiple small, oval, hypoechoic areas; and may have increased
blood flow at US. Enlarged lymph nodes with increased central
blood flow may be observed in acute inflammation of salivary glands.
In severe cases, abscess formation may occur.
Recurrent infections may cause gland atrophy and fibrous tissue
replacement of the normal gland.
Ultrasound is highly sensitive in the detection of parotid calculus
formation and is the initial imaging modality of choice in patients
with a history of recurrent swelling suggestive of calculus disease.
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