Clinical characteristics that predict parotid abscess: An observational cohort study

Abstract

Background We analysed clinical factors that are predictive of a diagnosis of parotid abscess among patients with bacterial parotitis. Material and methods This retrospective study included 64 hospitalised patients who were diagnosed with parotid abscess, or bacterial parotitis. Data on patient demographics, clinical characteristics, and clinical management were collected. Predictive factors for parotid abscess were evaluated using univariate and multivariate analysis. Results There were 25 patients with parotid abscess and 39 with bacterial parotitis. All patients presented with moderate-to-severe disease, required parenteral antibiotics, or had indicators for surgical drainage. Patient profiles and immune status were not significantly associated with parotid abscess. However, parameters that were significantly related to parotid abscess were subacute presentation (approximate 10.4 days) (p value = 0.016), fluctuation (p value < 0.001), and normal (haemoglobin) Hb level >12–13 g/dL (p value = 0.035). Imaging indicated the abscess location, extension and evaluated the complications. Surgical drainage with small skin incision and antibiotic coverage for possible pathogens, in particular Staphylococcus spp. and Streptococcus spp. produced favourable patient outcomes. Complication was identified in 3 cases with included septicaemia and cellulitis of the face and parapharyngeal space. Conclusions Among bacterial parotitis patients, parotid abscess should be considered in whom presented with subacute duration of symptoms, enlarged glands with fluctuation, and non-anaemic problem. Instead of standard skin incision of parotidectomy, small vertical skin incision over a well localised abscess pocket or fluctuated area achieved the good results.

Localized massive staphylococcal pericardial abscess with atypical presentation

“…Our preoperative diagnosis of this patient was massive anterior pericardial cyst that is functionally compromising the right side of the heart due to the CT image and masked signs and symptoms of pericardial staphylococcal infection. Unusual presentations for abscess formation are not uncommon [ 11 , 12 ]. Therefore, absence of aggressive sign and symptoms of infection and presence of localized pericardial lesion could not exclude the presence of pericardial abscess.…”

Fistula Salival: presentación atípica en parotiditis bacteriana, apropósito de un caso

“…La presentación clínica de esta entidad se caracteriza por aparición repentina de aumento de volumen en región parotídea que se extiende hasta el ángulo de la mandíbula, con signos de flogosis (rubor, calor y dolor) y borramiento del mismo. Al examen físico de la cavidad oral se puede evidenciar la desembocadura del conducto parotídeo roja, congestiva o con salida de secreción purulenta (4,5) . En el caso mencionado se observaron manifestaciones clínicas típicas como aumento de volumen en la región parotídea unilateral con extensión al ángulo de la mandíbula, calor local, eritema localizado y dolor de fuerte intensidad, asociado a fiebre elevada y leucocitosis en correlación con lo descrito en la literatura consultada.…”

Bi-Institutional Analysis of Microbiological Spectrum and Therapeutic Management of Parotid Abscesses

“…A PA is characterized by a localized collection of pus within the parotid gland, resulting from acute purulent sialadenitis, generally caused by ascending infection. Prompt diagnosis and appropriate management are crucial to prevent complications such as septicemia, osteomyelitis, mediastinitis or facial nerve palsy [2][3][4].…”