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In approximately a third of individuals exposed to infection there is no apparent clinical illness despite positive serology. (asymptomatic infection is common in children) (1). Clinical symptoms are much more severe in adults & adolescents than in children (2).

There is an incubation period of 14 to 25 days. A prodrome of non specific symptoms like fever, malaise myalgias, and anorexia may be followed by enlargement of one or both parotid glands, developing over a period of 1 to 3 days.

  • older children may complain of tenderness over the parotid gland and occasionally ear ache before actual swelling becomes evident (2)
  • the parotid enlargement may displace the ear lobe upwards and obliterate the space between the mandible and the sternomastoid muscle
  • the swelling may even impede chewing or pronunciation of words (3)
  • other salivary glands, namely the submandibular and sublingual salivary glands, may also become inflamed.
  • upon looking in the mouth, the tonsils may be displaced towards the midline.

The swellings settle in 7 to 10 days and there is no specific treatment. Salivary gland swelling is not apparent in about 30% of cases. Other causes of unilateral or bilateral parotitis can be divided into infectious & non infectious causes

  • infectious causes - include other viral agents like parainfluenza, coxsackievirus, influenza A, Epstein-Barr virus, adenovirus, and suppurative bacterial infection.
  • non infectious causes - include salivary calculi, tumors, sarcoid, and Sjögren’s syndrome, ingestion of starch or thiazides, and iodine sensitivity (2).

Reference

Last reviewed 01/2018

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