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Paediatric Parotid Abscess: A Rare Presentation
Sounak Patra1, Sauradeep Das1, Prachurya Tamuli1
1Department of ENT, NEIGRIHMS, Shillong, 793018 India.
Insights
Acute parotitis in children can lead to parotid abscesses. This case highlights the importance of imaging, like ultrasound with color Doppler, for diagnosing and managing pediatric parotid abscesses, especially those stemming from dental infections.
Area of Science:
- Pediatric Infectious Diseases
- Otolaryngology
- Medical Imaging
Background:
- Acute parotitis in children is common, with various predisposing factors.
- Infections can lead to parotid abscesses requiring intervention.
- Dental infections are an uncommon cause of pediatric parotid abscesses.
Purpose of the Study:
- To present a case of pediatric parotid abscess secondary to dental infection.
- To emphasize the role of imaging in diagnosis and management.
- To highlight the rarity of dental origin for parotid abscesses in children.
Main Methods:
- Case presentation of a 9-year-old female child with parotid abscess.
- Clinical examination and ultrasonography with color Doppler for diagnosis.
- Surgical drainage as the management for refractory abscess.
Main Results:
- The parotid abscess required surgical drainage.
- Ultrasonography with color Doppler proved effective for diagnosis and guiding intervention.
- The abscess originated from a preceding dental infection, a rare occurrence in pediatric patients.
Conclusions:
- Parotid abscesses in children, particularly those from dental origins, necessitate prompt diagnosis and management.
- Ultrasonography with color Doppler is a crucial tool for evaluating parotid abscesses.
- While surgical drainage is sometimes required, conservative measures and accurate imaging are key.
Abstract:
Acute parotitis in children is a common occurrence with predisposing factors including ductal dysfunction, poor oral hygiene or dental infections, immunosuppression, dehydration, or a pre-existing Warthin's tumour. Bacterial or viral infections of the intra-parotid and peri-parotid lymph nodes or the parotid gland parenchyma results in inflammatory followed by suppurative changes which leads to formation of parotid abscess. Surgical drainage is necessary in parotid abscesses not responding to conservative management. Surgical intervention is invasive and has associated risks of injury to the facial nerve and poor cosmetic outcome. We present a case of parotid abscess in a 9-year-old female child which required surgical drainage. In literature, parotid gland abscess arising from a preceeding dental infection in paediatric age group is an uncommon occurence and limited number of cases have been documented. The first line of imaging is ultrasonographic examination of the parotid gland which adds on to the clinical examination. In combination with color doppler, sonography is of immense assistance for diagnosis and evaluation of therapeutic efficacy and also helps guide aspiration or incision and drainage.
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