Symptoms

The acute inflammation of the parotid gland is usually manifested by the sudden appearance of the typical symptoms. In many of the affected patients, the symptoms are only manifested on one side of the face. Various triggers, however, provoke inflammation of the parotid gland on both sides and thus the appearance of the classic symptoms on both sides.

If salivary stones are responsible for the development of the acute inflammation of the parotid gland, the symptoms may even occur some time before the actual inflammatory reaction begins. However, this phenomenon is strongly dependent on the size of the salivary stones. Regardless of the cause, the affected patients describe approximately the same symptom complexes.

Particularly during food intake, pronounced swelling of the face or in the cheek region can be observed. In addition, most of the affected patients notice a clear hardening and painful pressure on the inflamed half of the face. The connection between “increased symptoms” and food intake can be explained quite simply.

Inflammatory processes in the area of the parotid gland cause the swelling of the tissue to block the flow of saliva. During eating, however, the parotid gland begins to produce larger amounts of saliva. This ultimately leads to a high pressure development within the gland.

The affected patient feels severe pain, the swelling increases and the parotid gland hardens noticeably. In addition to the local complaints, an acute inflammation of the parotid gland in most cases also leads to the development of general symptoms. Most patients develop fever due to the inflammatory processes.

In rare cases, there is even pronounced chills. Furthermore, the skin in the parotid gland area is usually reddened and overheated. In very pronounced cases, purulent fluid is drained into the mouth during the course of the disease.

In these cases, patients notice an unpleasant taste. The sometimes severe swelling can also block the temporomandibular joint and make the chewing process more difficult. In most cases, the affected patients can hardly open their mouths.

The typical symptoms of an acute inflammation of the parotid gland can vary greatly depending on the patient and the severity of the disease.In some cases, the acute inflammation of the parotid gland is even completely without symptoms. Only during eating does the blockage of the salivary discharge cause a slight swelling in the area of the cheek. and swelling behind the parotid gland often occur together with parotitis.

In most cases, they are even the reason for the inflammation of the large salivary gland. Poor oral and dental hygiene is known to cause caries and inflammation of the gums. If the mucous membrane on the molars is also affected, this can promote an ascending infection.

The excretory duct of the parotid gland is located opposite the second molar in the direction of the cheek and represents a possible entry port for bacteria from the oral cavity. If the bacteria of the oral flora rise in the excretory duct, they can infect the parotid gland. From a temporal point of view, toothache or inflammation of the oral mucosa usually occurs first before reactive parotid gland inflammation can occur.

It is not important how severe the toothache is, but only how close the affected tooth is to the parotid gland. If severe toothache leads to a reduced food intake, saliva production is additionally reduced so that the bacteria are not flushed out again when saliva is drained, thus accelerating the disease process. Both infectious and non-infectious causes play a decisive role in the development of an acute inflammation of the parotid gland.

The most common cause of acute inflammation of the parotid gland is the formation of salivary stones (sialolite). By depositing a small salivary stone, the excretory duct of the parotid gland can be blocked, resulting in salivary congestion. The oral cavity is naturally richly populated by bacterial pathogens.

These rise through the excretory duct into the parotid gland. Without the presence of salivary stones, however, the bacterial pathogens can be flushed out with the salivary flow. However, if there is a pronounced blockage of the excretory duct, the bacterial pathogens multiply and initiate an inflammatory cascade.

This leads to the development of inflammatory processes in the parotid gland area. However, an acute inflammation of the parotid gland is usually not triggered by a single factor. Rather, it is assumed that the acute inflammation of the parotid gland is a so-called “multifactorial disease”, in which the interaction of various risk factors plays a decisive role in the development of the disease.

A change in the natural composition of saliva is also a possible cause of acute parotid gland inflammation. Above all, an excess of calcium (hypercalcaemia) or a low fluid content should play a decisive role in this context. In addition, patients with poorly controlled diabetes mellitus, gout and/or diseases that are associated with an impairment of the glandular ducts have a much higher risk of developing the disease.

Especially in patients suffering from cystic fibrosis, recurrent inflammation of the parotid gland can be observed. However, an increased risk of developing an acute inflammation of the parotid gland can also have other causes. In particular, anatomical constrictions, scar tissue or tumors can impede the outflow of saliva and thus promote inflammatory processes.

In addition, poor or inadequate oral hygiene can contribute to an increased risk of acute parotid gland inflammation. In addition to these known risk factors, it has recently been assumed that there is a connection between the increased incidence of parotid gland inflammation and disturbances in the electrolyte and water balance. Furthermore, it can be observed in everyday clinical practice that inflammatory processes in the area of the oral mucosa (stomatitis) often tend to continue into the parotid glands.

Causes at a glance: Bacterial infections of the parotid gland Cancer of the parotid gland Impaired drainage of the salivary gland ducts Disturbances in the electrolyte and/or water balance Drugs that reduce the flow of saliva

Bacterial infections of the parotid gland
Cancer of the parotid gland
Outflow obstructions of the salivary gland ducts
Disturbances in the electrolyte and/or water balance
Salivary stones
Diuretics
Antidepressants
Antihistamines
Beta- Blocker
Viral diseases (z.B. Mumps, cytomegaly, Coxsackie A virus)
Autoimmune diseases (collagenosis, Sjögren’s syndrome)
Post-therapeutic (e.g. after radiotherapy)

Whether parotid gland inflammation is contagious depends on the cause of the inflammation. A unilateral parotid gland inflammation is usually not contagious if sufficient hygiene measures such as regular hand washing are observed.

The bacterial pathogens can only be transmitted via a droplet or smear infection that originates in the oral cavity. So if the person concerned washes his hands after coughing or after contact with the oral mucosa, transmission of the pathogens is unlikely. If transmission does occur, however, bacteria are transmitted that everyone has in their own mouth.

The pathogens that cause unilateral parotitis are usually streptococci, which are part of the natural oral flora in healthy people. If the parotid glands are inflamed on both sides, the viral disease mumps is an obvious cause. In this inflammation of the parotid glands, which often occurs in childhood, the viral pathogens can be transmitted to contact persons from about one day before the swelling occurs until about three days later, with mumps being contagious during this period.

As a rough guide to the infectiousness of parotid gland inflammation, one can therefore use the symptoms of the disease. If the affected person has pain and one-sided swelling, contact with others is rather harmless. If the affected person also suffers from fever and develops a swelling of both parotid glands, he should stay at home and avoid unnecessary contact.