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SARS-CoV-2 associated unilateral parotitis in children: A case report and literature review
Andrea Marino1, Giovanni Cacciaguerra2, Serena Spampinato1,3
1Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Catania, ARNAS Garibaldi Hospital, I-95122 Catania, Italy.
Insights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause unusual symptoms like parotitis. This case highlights SARS-CoV-2 as a potential cause of parotitis and sialadenitis in children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Otolaryngology
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily impacts the respiratory system.
- Atypical clinical manifestations of SARS-CoV-2 infection are increasingly recognized, particularly in pediatric populations.
- Parotitis and sialadenitis are inflammatory conditions affecting the salivary glands, commonly caused by viral infections like mumps or influenza.
Observation:
- A 12-year-old child presented with acute onset of right unilateral parotitis and sialadenitis, characterized by fever, swelling, tenderness, and skin hyperemia.
- Diagnostic evaluation included a positive SARS-CoV-2 molecular swab.
- Ultrasound imaging revealed enlarged parotid and sublingual glands with reactive lymph nodes, consistent with parotitis and sialadenitis.
Findings:
- The case confirms a direct association between SARS-CoV-2 infection and the development of parotitis and sialadenitis in a pediatric patient.
- The clinical presentation mimicked typical causes of parotitis, underscoring the need for broader diagnostic considerations during the Coronavirus disease 2019 pandemic.
- Laboratory and imaging findings supported the diagnosis of viral-induced sialadenitis attributed to SARS-CoV-2.
Implications:
- Clinicians should consider SARS-CoV-2 infection in the differential diagnosis of pediatric parotitis and sialadenitis, alongside common viral etiologies.
- Early recognition and diagnosis of atypical SARS-CoV-2 manifestations are crucial for appropriate patient management and public health surveillance.
- Further research is warranted to understand the mechanisms underlying SARS-CoV-2-induced salivary gland involvement and its prevalence.
Abstract:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection usually affects the respiratory system; however, a number of atypical manifestations of this disease have also been reported, especially in children. The present study reports a case of a 12-year-old presenting with right unilateral parotitis and sialadenitis and SARS-CoV-2 infection. The young patient, after a 3-day history of fever, was brought to our clinic (Polyclinic University Hospital 'G. Rodolico', Catania, Italy) for the sudden onset of unilateral parotitis accompanied by sialadenitis and hyperaemia of the skin, which was tender to touch. The SARS-CoV-2 molecular swab was positive; the ultrasound of the affected region showed an increase in the volume of the parotid and sublingual gland and reactive lymph nodes compatible with parotitis and sialadenitis. This case suggests that, in the present Coronavirus disease 2019 pandemic, SARS-CoV-2 should be included in the differential diagnosis of parotitis and sialadenitis along with mumps and flue. Notably, a respiratory panel and serology for other potential causes are needed in case of parotitis-like disease.
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