Acute Nonsuppurative Sialoadenitis

Aka: Acute Nonsuppurative Sialoadenitis, Viral Sialoadenitis, Acute Nonsuppurative Sialadenitis, Viral Sialadenitis, Acute Viral Sialadenitis

1. See Also
   1. Mumps
   2. Acute Suppurative Sialoadenitis
   3. Neonatal Sialadenitis
   4. Sialolithiasis
   5. Salivary Gland Tumor
2. Epidemiology
   1. Common in children
      1. Mumps cases are in children under age 15 years in 85% of cases
   2. Less common in adults
      1. Sialolithiasis, Bacterial Sialadenitis affect adults most commonly
3. Causes
   1. Mumps Parotitis
      1. Historically, the most common cause prior to Vaccination
         1. Incidence reduced by 99% following routine Vaccination
      2. Transmitted easily by airborne droplet spread
      3. Local pain and swelling of Parotid Glands (may start unilaterally, but is bilateral ultimately)
      4. Associated with Otalgia and Trismus
   2. Human Herpesvirus 6 (Roseola or Exanthem Subitum)
   3. Epstein-Barr Virus Infection (Mononucleosis)
   4. Coxsackievirus Infection
   5. HIV Infection
      1. Diffuse cystic involvement of the major glands
      2. Presents with gradual, non-tender enlargement (typically affects Parotid Gland)
4. Symptoms and signs
   1. Swollen, tender Salivary Gland
5. Differential Diagnosis
   1. See Neck Masses in Children
   2. Acute Suppurative Sialoadenitis
   3. Recurrent Parotitis of Childhood
   4. Sialolithiasis
   5. Sjogren Syndrome
6. Labs
   1. Mumps serology
   2. Consider Monospot (or EBV and CMV serology)
   3. Consider HIV Test if risk factors
7. Management
   1. Hydration
   2. NSAIDs for analgesia
8. Course
   1. Mumps Parotitis resolves within 2 weeks
9. Complications
   1. See Mumps
10. Prevention
    1. MMR Vaccine is 88% effective in preventing Mumps
11. References
    1. Fedok in Noble (2001) Primary Care Medicine, p. 1770-1
    2. Chow in Mandell (2000) Infectious Disease, p. 699-700
    3. Walner in Cummings (1998) Otolaryngology, p. 5-121
    4. Wilson (2014) Am Fam Physician 89(11): 882-8 [PubMed]