Parotitis

Overview

Parotitis is inflammation of the parotid glands, the largest of the salivary glands, which sit just in front of and below each ear. When a parotid gland becomes inflamed, the cheek and area near the jaw and ear swell and become painful.

Parotitis can be caused by viral infections, the most well-known being mumps, by bacterial infection, or by blockage of the gland's duct from a stone or thickened saliva. It may affect one or both glands. Most cases improve with treatment of the cause and supportive care, but bacterial parotitis and blocked, infected glands need prompt medical attention.

Symptoms

Symptoms reflect inflammation and swelling of the gland and may include:

• Swelling of one or both cheeks, in front of and below the ear
• Pain or tenderness in the affected area, often worse with eating
• Dry mouth
• A bad taste in the mouth or pus draining into the mouth in bacterial infection
• Difficulty opening the mouth fully
• Fever and feeling generally unwell, especially with infection

Signs of a more serious bacterial infection include rapidly worsening swelling, redness and warmth over the gland, high fever, and pus. Spreading redness, difficulty breathing or swallowing, or severe swelling require urgent care.

Causes

Parotitis has several possible causes:

• Viral infection: Mumps is the classic cause; other viruses can also inflame the gland.
• Bacterial infection: Often occurs when saliva flow is reduced, allowing bacteria from the mouth to infect the gland, especially in dehydrated, older, or unwell people.
• Blockage: A salivary stone or thickened saliva can obstruct the duct and lead to inflammation and infection.
• Autoimmune and other conditions: Disorders such as Sjogren's syndrome and certain immune conditions can cause recurrent gland inflammation.

Risk Factors

• Dehydration or reduced saliva flow
• Older age and recent illness or surgery
• Poor oral hygiene
• Medications that dry the mouth
• Not being vaccinated against mumps
• Salivary stones or autoimmune conditions affecting the glands

Diagnosis

Diagnosis is based on examination and the pattern of symptoms, with tests to find the cause:

• Physical examination: Checking the swollen gland and looking for pus at the duct opening inside the mouth.
• Imaging: Ultrasound or CT can show abscesses, stones, or gland changes.
• Laboratory tests: Blood tests or swabs may identify infection; specific testing can confirm mumps.

The cause guides treatment, so distinguishing viral, bacterial, and obstructive parotitis is important.

Treatment

Treatment depends on the underlying cause.

• Viral parotitis (such as mumps): Supportive care with rest, fluids, pain relief, and time, as the body clears the virus.
• Bacterial parotitis: Antibiotics, good hydration, warm compresses, and measures to stimulate saliva flow such as sour candies or gum.
• Obstruction: Treating a salivary stone or blockage to restore saliva flow.
• Abscess: A collection of pus may need to be drained.
• Underlying conditions: Managing autoimmune or other disorders that cause recurrent inflammation.

Maintaining hydration and oral hygiene supports recovery and helps prevent recurrence.

Prevention

• Stay well hydrated, especially when ill or after surgery
• Maintain good oral hygiene
• Get the MMR vaccine, which protects against mumps
• Stimulate saliva flow with sugar-free gum or tart foods if you are prone to gland problems
• Review drying medications with your doctor if you have recurrent episodes

When to See a Doctor

See a doctor if you have painful swelling of the cheek or jaw area, especially with fever or pus draining into the mouth. Seek urgent care if swelling worsens rapidly, the skin becomes red and hot, you have a high fever, or you develop difficulty breathing or swallowing, as these may indicate a serious infection or abscess.

Related Topics

Frequently Asked Questions

References

1. MedlinePlus, U.S. National Library of Medicine. Salivary gland infections.
2. Centers for Disease Control and Prevention (CDC). Mumps.
3. American Academy of Otolaryngology-Head and Neck Surgery. Salivary gland disorders.
4. Mayo Clinic. Salivary gland infections.