Long-Term Effects of Acute Parotitis: Symptoms and Solutions

Complications of acute parotitis?

Hello, Doctor.
Since 2015, I have experienced inflammation of the left parotid gland every so often, with a total of three episodes.
I have eliminated fried foods from my diet and underwent a CT scan to rule out the possibility of stones.
Unfortunately, I had another severe episode of inflammation on Christmas 2019.
The CURAM I used during previous episodes was no longer effective in controlling the infection, and switching to another antibiotic also yielded poor results.
I was referred from the ENT department to the Infectious Disease department, where the physician noted that the swelling on my cheek was approximately 7-8 cm and stated they had never seen such significant swelling before.
After being hospitalized for two weeks, the swelling reduced to some extent, although it was still visibly swollen.
The hospital discharged me, citing that only severe cases would be kept during the New Year period, and I continued to take antibiotics for a while afterward.
When the doctor declared that I could stop taking antibiotics, I sought traditional Chinese medicine to help with drainage and reduce swelling due to fears of the COVID-19 pandemic, continuing the herbal treatment until mid-2021.

However, I have been troubled by the fact that even though I drink a large amount of water daily (over 5000 cc), my parotid gland still easily becomes obstructed during the evening until bedtime.
The symptoms include mild swelling, pain, and warmth in the parotid area.
If I’m lucky, I wake up the next day feeling better; if not, the swelling can last for 3-4 days, which makes me anxious about the possibility of reinfection.
I would like to ask the doctor if this condition is due to residual pus in the parotid gland.
Is there a possibility that it could heal on its own in a few years? I am aware that I have immune issues and have not received any vaccinations.
Currently, I am hesitant to visit a large hospital.
I would like to know if there is a chance for self-recovery or if I ultimately need to seek hospital treatment.
Please provide your advice.

Wishing you a happy belated New Year, and may you have peace, health, and prosperity in the coming year!

Mr. Huang, 30~39 year old female. Ask Date: 2023/01/27

Dr. Zheng Jueyi reply Otolaryngology

Hello, it is common for the salivary duct to become obstructed after an infection, which can lead to swelling when there is a high demand for saliva production after eating.
If there are no persistent symptoms such as redness, swelling, heat, or pain, it may not necessarily indicate a bacterial infection.
If the issue continues to be bothersome, it may be advisable to visit a medical center for a salivary gland endoscopy to determine if there are any blockages or narrowing of the ducts.

Reply Date: 2023/01/27

More Info

Acute parotitis, particularly recurrent cases, can be quite challenging to manage, especially when it leads to significant swelling and discomfort. Your history of recurrent inflammation of the left parotid gland, along with the severe episode you experienced in 2019, suggests that there may be underlying issues contributing to your symptoms.
Firstly, it's important to understand that the parotid glands can become inflamed due to various factors, including viral infections (like mumps), bacterial infections, duct obstruction (often due to stones or thickened saliva), or even autoimmune conditions. Given that you've had multiple episodes and have undergone imaging studies to rule out stones, it seems that your condition may not be solely due to obstructive factors.
The fact that you have experienced significant swelling (7-8 cm) and have had to switch antibiotics multiple times indicates that the infection may have been particularly aggressive or resistant to standard treatments. The lingering symptoms you describe, such as swelling, tenderness, and warmth in the parotid area, suggest that there may still be some inflammation or possibly residual infection that has not completely resolved.
Drinking large amounts of water is beneficial as it helps to thin the saliva, potentially reducing the risk of blockage in the ducts. However, if you are still experiencing symptoms of swelling and pain, it may indicate that there is still some underlying issue that needs to be addressed.
Regarding your concern about whether this condition can resolve on its own, it is possible for some cases of acute parotitis to improve with time and conservative management, especially if the underlying cause is addressed. However, recurrent episodes, particularly those that lead to significant swelling and discomfort, often require further evaluation and possibly intervention.
Given your history of immune issues and the fact that you have not received vaccinations, it is crucial to approach this situation with caution. While you may feel apprehensive about visiting a hospital due to the ongoing pandemic, it is important to prioritize your health. A thorough evaluation by an ear, nose, and throat (ENT) specialist or an infectious disease expert may be necessary to determine if there are any underlying conditions that need to be treated, such as chronic infection or autoimmune issues.

In summary, while there is a possibility that your condition could improve over time, the recurrent nature of your symptoms and the severity of your past episodes suggest that further medical evaluation is warranted. It is advisable to consult with a healthcare professional who can provide a comprehensive assessment and discuss potential treatment options, which may include imaging studies, blood tests, or even surgical intervention if necessary. Your health and well-being should be the priority, and seeking medical advice is a crucial step in managing your condition effectively.
Wishing you a healthy and prosperous new year as well!

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