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El Omri M, Jemli S, Belakhdher M, Kermani W. Neonatal Suppurative Parotitis: Case Report and Review of Literature. EAR, NOSE & THROAT JOURNAL 2024:1455613241234281. [PMID: 38476055 DOI: 10.1177/01455613241234281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
Neonatal suppurative parotitis is a rare condition that is diagnosed primarily through clinical evaluation. The prognosis is generally good. In this report, we present the case of a 21-day-old female infant who was treated in our ENT department for neonatal suppurative parotitis. The patient presented with a feverish, hard, red, and tender swelling of the parotid loge which displaced the right earlobe outward. In addition, purulent exudate was observed from Stensen's duct. A computed tomography scan of the cervical and cerebral regions revealed a swollen right parotid gland with heterogeneous density and enhancement, but no detectable collection. The patient received intravenous antibiotics for 48 hours, resulting in a favorable outcome without the need for surgical treatment. The aim of this study is to emphasize the diagnostic and therapeutic aspects of this clinical condition. Suppurative parotitis should be suspected by the clinician in newborns who present with an inflammatory preauricular swelling, with or without contributing factors. The outcome is generally favorable, and complications are rare with timely and appropriate medical treatment.
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Affiliation(s)
- Malika El Omri
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Safaa Jemli
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
- Ear Nose and Throat Department and Cervical Surgery, Farhat Hached Hospital, Medicine University, Sousse, Tunisia
| | - Mouna Belakhdher
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
- Ear Nose and Throat Department and Cervical Surgery, Farhat Hached Hospital, Medicine University, Sousse, Tunisia
| | - Wassim Kermani
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
- Ear Nose and Throat Department and Cervical Surgery, Farhat Hached Hospital, Medicine University, Sousse, Tunisia
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Paouris D, Dallos T, Pitiriga V. Polymicrobial Acute Suppurative Parotitis in a 33-Day-Old Infant: A Case Report and Review of the Literature. Clin Pediatr (Phila) 2022; 61:802-807. [PMID: 35678072 DOI: 10.1177/00099228221102712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Acute suppurative parotitis (ASP) of neonates is a rare condition characterized by irritability, erythema, and tenderness of the affected gland. METHODS/RESULTS Only few cases have been reported in Engilsh literature, mostly in male neonates, in a unilateral fashion. In our case, a polymicrobial etiology (Klebsiella pneumoniae, Staphylococcus aureus, Acinetobacter ursingii, and Acinetobacter junii) was found. Based on the review of the microbiological findings of cases of ASP in English literature for the years 1970 to 2020, S. aureus is the most commonly isolated microorganism (47% of the total 65 patients). Our patient was born with a C-section procedure and was not breast-fed, making dysbiosis along with the usage of the feeding bottle, possible risk factors for the development of ASP. CONCLUSIONS ASP may be due to polymicrobial etiology. Initial presentation in neonates may not include typical signs and symptoms, like fever. Aseptic technique of oral procedures is of utmost importance also in immune-competent neonates.
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Affiliation(s)
- D Paouris
- Pediatric Otorhinolaryngologic Clinic of the Medical Faculty of Comenius University and the National Institute of Children's Diseases, Bratislava, Slovakia
| | - T Dallos
- Pediatric Clinic of the Medical Faculty of Comenius University and the National Institute of Children's Diseases, Bratislava, Slovakia
| | - V Pitiriga
- Department of Microbiology, Medical School, University of Athens, Athens, Greece
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Deepak K, Garima G, U J. Bilateral acute neonatal suppurative parotitis: A rare finding in neonatal age. J Neonatal Perinatal Med 2015; 8:4700U01136G65614. [PMID: 25758001 DOI: 10.3233/npm-15814056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Acute suppurative parotitis is a rare entity in neonates. Bilateral involvement is extremely rare. Low birth weight, prematurity, gavage feeding, dehydration, sepsis are all known risk factors. Staphylococcus aureus is the most common organism, other organisms responsible for parotitis are streptococcus, E. coli, pseudomonas and klebsiella. We report a neonate suffering from bilateral acute suppurative parotitis with an unusual causative association. CPAP and its association for acute suppurative parotitis has been proposed.
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Affiliation(s)
- K Deepak
- Department of Pediatric, Lok Nayak Hospital and associated Maulana Azad Medical College, New Delhi, India
| | - G Garima
- Department of Pediatric, Lok Nayak Hospital and associated Maulana Azad Medical College, New Delhi, India
| | - J U
- Department of Pediatric, Lok Nayak Hospital and associated Maulana Azad Medical College, New Delhi, India
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Aletayeb SMH, Sepehran A, Javaherizadeh H. Suppurative parotitis in a girl: a case report from ahvaz, iran. Jundishapur J Microbiol 2014; 7:e12309. [PMID: 25485063 PMCID: PMC4255378 DOI: 10.5812/jjm.12309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 09/08/2013] [Accepted: 09/25/2013] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Neonatal parotitis is a rare disease. Neonatal suppurative parotitis commonly presents with facial swelling, irritability, tenderness of parotid region, and with or without fever. Acute neonatal suppurative parotitis is one of the differential diagnoses of facial swelling with a prevalence of 3.8/10'000 of neonatal admission. CASE PRESENTATION A 32-day-old girl with fever and restlessness was admitted in the hospital. Left facial swelling was found during physical examination. Redness was observed in the face. Prenatal history was normal. Birth weight was 3500 g. Body weight, length, and head circumference were 4300 g (75 th percentile), 52 cm (50 th percentile), and 38 cm (75 th percentile), respectively. She was breastfed. Pulse and respiratory rates were 130/min and 50/min, respectively. Axillary temperature was 37.8°C. Head examination revealed normal sized fontanel (1.5 × 1.5 cm) without bulging. Eye and ear were normal. Abdominal examination revealed no abnormal findings. Results of urine analysis and culture were normal. Blood urea nitrogen, sodium, potassium, and blood sugar were normal. Blood amylase was 10 U/L. Bilateral multiple reactive lymph node (size = 6 × 10 mm) at anterior cervical chain with a left facial swelling was observed in ultrasonography report. Pus was obtained following gentle pressure on Stensen's duct. Staphylococcus aureus was detected in the microscopic and microbiological evaluations.The patient received a seven-day treatment course with vancomycin and amikacin. Neonate was discharged in a good condition. CONCLUSIONS Acute suppurative parotitis should be suspected in infants with fever, and irritability in pre-auricular region; and should be treated with appropriate antibiotics.
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Affiliation(s)
- Seyed Mohammad Hassan Aletayeb
- Department of Pediatrics, Abouzar Children's Hospital, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Ashraf Sepehran
- Department of Pediatrics, Abouzar Children's Hospital, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Hazhir Javaherizadeh
- Department of Pediatrics, Abouzar Children's Hospital, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding author: Hazhir Javaherizadeh, Department of Pediatrics, Abouzar Children's Hospital, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel/Fax: +98-6113337681, E-mail:
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Cizmeci MN, Kanburoglu MK, Akelma AZ, Malli DD, Akin K, Tatli MM. Neonatal inflammatory submandibular sialadenitis associated with prenatal methyldopa exposure. J Pediatr Pharmacol Ther 2014; 19:132-134. [PMID: 25024674 PMCID: PMC4093666 DOI: 10.5863/1551-6776-19.2.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
Inflammation of a salivary gland is an uncommon condition in the neonatal period, and an isolated form of submandibular acute inflammatory sialadenitis is an exceptionally rare phenomenon. Among various conditions that might lead to submandibular acute inflammatory sialadenitis, maternal use of drugs during pregnancy should be questioned as there may be possible associations. Herein, we describe a late preterm infant who presented with a large submandibular mass. After excluding possible pathogenic causes, maternal use of methyldopa was believed to be the only factor associated with this condition. To the best of our knowledge, no such relationship has been documented in previously published literature.
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Affiliation(s)
- Mehmet Nevzat Cizmeci
- Department of Pediatrics, Division of Neonatology, Fatih University Medical School, Ankara, Turkey
| | - Mehmet Kenan Kanburoglu
- Department of Pediatrics, Division of Neonatology, Fatih University Medical School, Ankara, Turkey
| | | | | | - Kayihan Akin
- Department of Radiology, Fatih University Medical School, Ankara, Turkey
| | - Mustafa Mansur Tatli
- Department of Pediatrics, Division of Neonatology, Fatih University Medical School, Ankara, Turkey
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de Suremain N, Marteau E, Leruste A, Tournier C, Delamar AL, Carbajal R. Parotidite aiguë néonatale suppurative : revue de la littérature à propos d’une observation. Arch Pediatr 2014; 21:223-5. [DOI: 10.1016/j.arcped.2013.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 09/24/2013] [Indexed: 10/26/2022]
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Ismail EA, Seoudi TM, Al-Amir M, Al-Esnawy AA. Neonatal suppurative parotitis over the last 4 decades: report of three new cases and review. Pediatr Int 2013; 55:60-4. [PMID: 23039834 DOI: 10.1111/j.1442-200x.2012.03738.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Revised: 09/04/2012] [Accepted: 09/05/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Neonatal suppurative parotitis is a rare disease. Only 32 cases were reported in the English-language literature between 1970 and 2004. METHODS We searched Medline for acute, neonatal, bacterial, suppurative, parotitis, facial, preauricular swelling starting from 1970, limiting our search to the English-language literature. We reviewed all the reported cases together with three more managed in our department. RESULTS We identified nine new cases since 2004. The total number of patients reviewed was 44, including our patients. Most of them were male (77%). The majority developed unilateral inflamed parotid swelling (77%) and exuded pus from the ipsilateral Stensen duct. Fever was seen in fewer than half of them (47%). Premature babies constituted a third of the patients. Staphylococcus aureus was the leading causative agent (61%). Most patients responded well to conservative treatment with antibiotics (77%). The most frequently used combination of antibiotics was an anti-staphylococcal agent with either an aminoglycoside or a third-generation cephalosporin. A minority required surgical drainage. No deaths were reported in the group studied after 1970. CONCLUSION Neonatal suppurative parotitis is rare but easy to diagnose and if readily treated with appropriate antibiotics the outcome is excellent.
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Monolateral suppurative parotitis in a neonate and review of literature. Int J Pediatr Otorhinolaryngol 2012; 76:930-3. [PMID: 22575436 DOI: 10.1016/j.ijporl.2012.04.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 04/05/2012] [Accepted: 04/07/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Neonatal suppurative parotitis is a rare condition characterized by swelling, pain, and erythema over the affected gland. Antimicrobials and adequate hydration are an essential part of treatment. Surgical intervention is reserved for organized abscesses and for infections not responding to medical management. METHODS A case report and review of the literature. RESULTS Only few case reports and case series are reported in literature on neonatal parotitis. Transmission of bacteria seems to occur mainly by ascending spread through Stensen's duct, or by hematogenous spread from a distant focus. Dehydration, low birth weight, immune suppression, ductal obstruction, oral trauma and structural abnormalities of the parotid gland are recognised as risk factors. The most common pathogen is Staphylococcus aureus. Other less frequent agents are other Gram-positive cocci, Gram-negative bacilli and rarely anaerobic bacteria. Advances in antimicrobial therapy have improved both outcome and prognosis. CONCLUSIONS Thanks to the prompt antibiotic treatment complications are now drastically reduced. Ultrasound examination may help in the diagnosis and monitoring of clinical course.
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Herrera Guerra AA, Osguthorpe RJ. Acute neonatal parotitis caused by streptococcus pyogenes: a case report. Clin Pediatr (Phila) 2010; 49:499-501. [PMID: 20164068 DOI: 10.1177/0009922809360928] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Angel Alberto Herrera Guerra
- Department of Pediatrics, Division of Pediatric Infectious Disease of the University of Utah, Salt Lake City, UT 84158, USA.
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Abstract
A 3-day-old boy was admitted for right preauricular swelling. Examination showed a toxic looking neonate with poor neonatal reflexes. There was erythema and swelling of 4 × 3 cm at the level of the right cheek. Laboratory investigation pointed to a bacterial infection. With parenteral antibiotics, the lesion resolved completely.
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