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A 60-year-old female complained of painless parotid swelling. Cette patiente âgée de 60 ans se plaint d'une tuméfaction douloureuse de la parotide.




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US image shows longitudinal and transversal section through the left parotid gland and Stenon duct in a patient with acute, painful parotid swelling. The gland is enlarged, hypoechoic and inflamed Stenon duct is dilated and present little purulence. The appearances are consistent with acute bacterial parotiditis (infection relates to sepsis of adjacent teeth extraction). Les différents clichés montrent des coupes longitudinales et transversales de la glande parotide gauche et le canal de Stenon chez une patiente présentant une tuméfaction douloureuse de la parotide gauche. La glande est large, le canal de sténon hypoéchogène, dilaté contient un peu de pus. L'aspect est celui d'une parotidite aigue bactérienne. (L'infection est liée à une extraction d'une dent adjacente).




Acute bacterial parotiditis
Parotidite aigue bactérienne


Acute parotiditis

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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.

Ultrasound :
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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* 3 : Miziara ID, Campelo VE. Infantile recurrent parotitis: follow up study of five cases and literature review. Rev Bras Otorrinolaringol (Engl Ed). 2005 Sep-Oct;71(5):570-5.
* 4 : Howlett DC. High resolution ultrasound assessment of the parotid gland. Br J Radiol. 2003 Apr;76(904):271-7. Review.
* 5 : : Thiede O, Stoll W, Schmal F. [Clinical aspects of abscess development in parotitis] HNO. 2002 Apr;50(4):332-8.
* 6 : : Shimizu M, Ussmuller J, Donath K, Yoshiura K, Ban S, Kanda S, Ozeki S, Shinohara M. Sonographic analysis of recurrent parotitis in children: a comparative study with sialographic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998 Nov;86(5):606-15.
* 7 : Nusem-Horowitz S, Wolf M, Coret A, Kronenberg J. Acute suppurative parotitis and parotid abscess in children. Int J Pediatr Otorhinolaryngol. 1995 May;32(2):123-7.