Parotid abscess: 15-year experience at a tertiary care referral center in Taiwan

Cheng, Li Hsiang; Wang, Hsing Won; Lin, Chien Ming; Shih, Cheng Ping; Chu, Yueng‐Hsiang; Hung, Wei Chen; Wang, Wei Yun; Wang, Chih Wei; Lee, Jih Chin

doi:10.4103/jmedsci.jmedsci_15_19

Cited by 5 publications

(5 citation statements)

References 18 publications

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“…Prior microbiological pro ling of PA revealed common pathogens like Staphylococcus spp., anaerobic bacteria, and Streptococcus spp. [3,10,11,27], consistent with our ndings. Furthermore, Klebsiella spp., Haemophilus spp., Enterobacter spp., Prevotella spp., Parvimonas spp., Burkholderia spp., Pseudomonas spp., Mycobacterium spp., non-Mycobacterium spp., Propionibacterium spp., and Brucella spp.…”

Section: Discussionsupporting

confidence: 91%

“…These ndings align with prior research, which showed that immunocompromising conditions were a predisposing factor for parotid abscess [10][11][12]. Furthermore, oro-dental issues [13], autoimmune disorders [14], ductal and/or parenchymal disorders [11,12,15], superinfected adenolymphoma [16], speci c disseminated diseases including melioidosis and tuberculosis [17,18], and immunode ciency due to conditions like HIV infection or diabetes mellitus [15,17,19] have been described as predisposing factors. Interestingly, although immunosuppression seems to predispose to PA, it did not have an impact on clinical course or complication rate in the present study.…”

Section: Discussionsupporting

confidence: 88%

“…In literature, antibiotic therapy typically involves aminopenicillin alone or in combination with a betalactamase inhibitor or clindamycin combined with third or fourth generation cephalosporins for patients with a high incidence of gram-negative bacterial infections [3,[9][10][11]13,20]. This is consistent with our ndings, where most patients received an aminopenicillin alone or in combination with a beta-lactamase inhibitor as empiric antibiotic therapy.…”

Section: Discussionsupporting

confidence: 88%

“…Furthermore, previous studies reported wound healing problems, which were not observed in our study [9]. Severe complications such as jaw osteomyelitis, temporal lobe abscess [23] craniocervical necrotizing fasciitis [24], descending mediastinitis [25], airway obstruction, septicemia, and septic shock [11,25,26] did not occur during the follow-up of our patients.…”

Section: Discussionmentioning

confidence: 41%

“…Furthermore, Klebsiella spp., Haemophilus spp., Enterobacter spp., Prevotella spp., Parvimonas spp., Burkholderia spp., Pseudomonas spp., Mycobacterium spp., non-Mycobacterium spp., Propionibacterium spp., and Brucella spp. have also been isolated in reported cases of PA [3,5,6,11,14,15,18,20,21,28]. In addition to the previously mentioned pathogens, our study identi ed Aggregatibacter aphrophilus, Corynebacterium kroppenstedtii, various Candida species, a single instance of methicillin-resistant Staphylococcus aureus (MRSA), and Francisella tularensis -a zoonotic pathogen typically associated with wild animals.…”

Section: Discussionmentioning

confidence: 63%

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

Mayer,

Esser,

Walker

et al. 2024

Preprint

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Background. A parotid abscess (PA) is a complication of an acute bacterial parotitis with a potentially life-threatening course. To date, data on the diagnosis and therapy of PA is sparse and mostly consists of case reports or case series. Therefore, this study aimed at comprehensively analyzing the microbiological spectrum and the therapeutic management in a bi-institutional setting. Methods. A retrospective clinical chart review was performed to identify all patients surgically treated for PA at two tertiary care centers in Germany. Data on demographics, clinical management and microbiological data including species identification, pathogenicity, type of antibiotic therapy, adjustment of antibiotics, antibiotic sensitivity testing, and smear test results were extracted. Intervention-related variables and etiology were analyzed for their statistical association with outcome variables. Results. Overall, 85 patients were included. Most patients (92.9%) underwent surgical incision. Around half of the patients (45.9%) were treated under local anesthesia. No facial nerve palsy was observed. The most frequently detected pathogens were Streptococci (n=23), followed by Staphylococcus aureus (n=6) including one case of methicillin-resistant Staphylococcus aureus. Most patients (68.2%) received an aminopenicillin +/- beta-lactamase inhibitor as empiric antibiotic therapy. In 6 cases the antibiotic therapy was modified after receiving the antibiogram. Four patients (5.2%) presented with recurrent PA. Etiology was idiopathic (42.4%) or obstructive, immunosuppressive, or tumorous (each 11.8%). Patients with a dental focus (p=0.007) had a longer duration of hospitalization. Chronic parotitis was associated with recurrence (p<0.001). Conclusion. The results show that the surgical therapy of PA under local anesthesia is safe. A dental examination should routinely be performed to rule out a dental focus. Obtaining a microbiological specimen in order to modify antibiotic therapy if necessary and a histopathological specimen to rule out a tumorous etiology is obligate.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 41%

Section: Discussionmentioning

confidence: 63%

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

Mayer,

Esser,

Walker

et al. 2024

Preprint

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Clinical characteristics that predict parotid abscess: An observational cohort study

Srivanitchapoom

Yata

2021

Annals of Medicine &Amp; Surgery

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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.

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Bi-institutional analysis of microbiological spectrum and therapeutic management of parotid abscesses

Mayer,

Esser,

Walker

et al. 2024

Head Face Med

View full text Add to dashboard Cite

Background A parotid abscess (PA) is a complication of an acute bacterial parotitis with a potentially life-threatening course. To date, data on the diagnosis and therapy of PA is sparse and mostly consists of case reports or case series. Therefore, this study aimed at comprehensively analyzing the microbiological spectrum and the therapeutic management in a bi-institutional setting. Methods A retrospective clinical chart review was performed to identify all patients surgically treated for PA at two tertiary care centers in Germany. Data on demographics, clinical management and microbiological data including species identification, pathogenicity, type of antibiotic therapy, adjustment of antibiotics, antibiotic sensitivity testing, and smear test results were extracted. Intervention-related variables and etiology were analyzed for their statistical association with outcome variables. Results Overall, 85 patients were included. Most patients (92.9%) underwent surgical incision. Around half of the patients (45.9%) were treated under local anesthesia. No facial nerve palsy was observed. The most frequently detected pathogens were Streptococci (n = 23), followed by Staphylococcus aureus (n = 6) including one case of methicillin-resistant Staphylococcus aureus. Most patients (68.2%) received an aminopenicillin ± beta-lactamase inhibitor as empiric antibiotic therapy. In 6 cases the antibiotic therapy was modified after receiving the antibiogram. Four patients (5.2%) presented with recurrent PA. Etiology was idiopathic (42.4%), followed by tumorous (12.9%), obstructive, and immunosuppressive (each 11.8%). Patients with a dental focus (p = 0.007) had a longer duration of hospitalization. Conclusion The results show that the surgical therapy of PA under local anesthesia is safe. A dental examination should routinely be performed to rule out a dental focus. Obtaining a microbiological specimen in order to modify antibiotic therapy if necessary and a histopathological specimen to rule out a tumorous etiology is obligate.

show abstract

Parotid abscess: 15-year experience at a tertiary care referral center in Taiwan

Cited by 5 publications

References 18 publications

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

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

Clinical characteristics that predict parotid abscess: An observational cohort study

Bi-institutional analysis of microbiological spectrum and therapeutic management of parotid abscesses

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