Mumps and Salivary Gland Tumors in Children - Otolaryngology

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Mumps, also known as epidemic parotitis, is a viral infection that primarily affects the salivary glands, particularly the parotid glands located near the jawline. It is caused by the mumps virus, which is part of the paramyxovirus family. The condition is characterized by swelling of the salivary glands, fever, headache, and muscle aches. In children, the symptoms can vary, and while many recover without complications, some may experience more severe issues, including orchitis (inflammation of the testicles) in males or oophoritis (inflammation of the ovaries) in females.

In your daughter's case, the swelling near her left ear could indeed be indicative of mumps, especially if she has received the mumps vaccine but still contracted the virus. Vaccination does not guarantee complete immunity, and breakthrough infections can occur, albeit usually with milder symptoms. The fact that the swelling has been responsive to antibiotics suggests that there may also be a secondary bacterial infection involved, which is not uncommon in cases of viral infections where the immune system is compromised.

The presence of a firm, movable mass in the area of the parotid gland, especially if it is painful upon pressure, raises concerns for both mumps and potential complications such as a salivary gland abscess or even a tumor. While benign tumors of the salivary glands, such as pleomorphic adenomas, can occur, they are less common in children. Malignant tumors, although rare, cannot be entirely ruled out without further investigation.

Given that your daughter has been hospitalized and is receiving antibiotics, it is crucial to monitor her symptoms closely. The fact that she is eating, sleeping, and engaging in normal activities is a positive sign, indicating that her overall condition is improving. However, the ongoing swelling and the nature of the mass necessitate further evaluation. A CT scan has already been performed, which is a good step in assessing the extent of the swelling and determining whether it is primarily inflammatory or if there is a mass that requires further investigation.

In terms of management, if the diagnosis of mumps is confirmed, treatment is generally supportive. This includes hydration, pain management, and monitoring for any complications. If the swelling persists or worsens, or if there are any signs of abscess formation, surgical intervention may be necessary to drain the abscess or to obtain a biopsy for histological examination to rule out malignancy.

It is also important to consider the history of skin infections and the cat scratch. Cat scratch fever, caused by Bartonella henselae, can lead to lymphadenopathy and may complicate the clinical picture. If there is any suspicion of this, serological testing may be warranted.

In summary, while your daughter's symptoms and the findings suggest a likely case of mumps with possible secondary infection, the characteristics of the mass warrant careful monitoring and possibly further diagnostic workup to rule out other conditions, including tumors. It is essential to maintain open communication with her healthcare team and follow their recommendations for further evaluation and treatment.