[Pediatric Mumps Parotid Abscess with Fistula Formation: A Case Report]

Mumps infection primarily leads to parotitis in children. While complications such as orchitis and encephalitis are uncommonly reported, the development of a parotid abscess due to mumps is extremely rare. We present the first described case of parotid abscess secondary to mumps, complicated by a persistent salivary fistula.

A 21-month-old unvaccinated, healthy boy presented with right-sided cheek swelling lasting 15 days. Prior treatment at home with amoxicillin-clavulanate did not yield improvement. Sonographic evaluation revealed an enlarged right parotid gland with a central hypoechoic focus and increased peripheral vascularity. Incision and drainage (I&D) were performed, and subsequent serological tests confirmed an acute mumps infection. Although the patient initially showed improvement post-drainage, he was readmitted two months later with an infected, persistent salivary fistula from the drainage site.

The report emphasizes the need for careful consideration before choosing a treatment modality for mumps-induced parotid abscesses. It is yet to be determined if mumps may predispose to fistula formation. Needle aspiration might be a more viable and safer option compared to traditional I&D. The management of parotid fistula requires a conservative approach, escalating to surgical interventions only if necessary. The presence of parotid abscess, especially in unvaccinated children, should alert clinicians to the possibility of mumps as an underlying cause and requires interventional considerations accordingly.