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Cases presenting as parotid abscesses in children
Riitta T Saarinen1, Kaija-Leena Kolho, Anne Pitkäranta
1Department of Otorhinolaryngology, Helsinki University Central Hospital, Helsinki, Finland. riitta.t.saarinen@hus.fi
International Journal of Pediatric Otorhinolaryngology
|March 31, 2007
Summary
Parotid abscesses in children often stem from acute bacterial infections. While intravenous antibiotics are key, surgical drainage aids recovery without causing complications like fistulas.
Area of Science:
- Pediatric Infectious Diseases
- Otolaryngology
- Surgical Pathology
Background:
- Parotid abscess is a rare but serious complication of acute suppurative parotitis.
- Management typically involves hospitalization, intravenous antibiotics, and surgical drainage.
Purpose of the Study:
- To describe the clinical presentation, treatment strategies, and outcomes for children with parotid abscess.
- To inform the development of optimal clinical guidelines for managing pediatric parotid abscesses.
Main Methods:
- Retrospective chart review of 10 pediatric patients (age ≤17) diagnosed with parotid abscess between 1996 and 2005.
- Analysis of clinical data, including prior symptoms, causative pathogens, diagnostic imaging, and treatment interventions.
Main Results:
- Bacterial cultures were positive in 60% of cases, with aerobic Gram-positive pathogens identified in four. One case involved parotid tuberculosis.
- All patients received intravenous antibiotics. Diagnostic imaging included ultrasound (90%) and MRI (10%).
- Surgical drainage or ultrasound-guided needle aspiration was performed in seven patients without complications; spontaneous rupture occurred in three cases. Two patients developed brachial cleft fistulas, with one experiencing abscess recurrence.
Conclusions:
- Pediatric parotid abscesses are frequently acute, multi-bacterial infections, not always linked to pre-existing parotid conditions.
- Intravenous antibiotic therapy is the primary treatment, complemented by surgical drainage to facilitate recovery.
- Appropriate drainage procedures minimize the risk of fistula formation.
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