acute suppurative mumps
Introduction
Introduction to acute suppurative mumps Acute purulent mumps (Acutepurulentparotitis) has been common in large abdominal surgery, so it is also known as postoperative parotitis, which is one of the serious complications. Due to the development of antibiotic applications and attention to maintaining normal access and water, electrolyte balance, it is currently rare. In addition to this, acute inflammatory patients with parotid glands are still seen. basic knowledge The proportion of sickness: 0.2% Susceptible people: no specific population Mode of infection: non-infectious Complications: abscess
Cause
Causes of acute suppurative mumps
Acute suppurative parotitis is rare, caused by purulent pathogens. The most common pathogen is Staphylococcus aureus, most of which are complicated by some patients with serious diseases (such as acute infectious diseases) or major surgery. .
Normally, the parotid gland secretes a large amount of saliva through the parotid duct drainage lumen, which helps to digest and flush the self-cleaning effect, serious illness and consumptive diseases, such as the late stage of acute infectious disease or chest, the patient after major abdominal surgery, the body's resistance is reduced, the whole body And the immune ability of the oral cavity is weakened, the salivary secretion is dysfunctional, and the pathogenic bacteria undergo retrograde purulent mumps through the parotid duct retrograde into the gland. In addition, the expansion of trauma or surrounding tissue inflammation, vermiculite, scar contracture, etc. affect saliva exclusion. Can also cause the disease.
Prevention
Acute suppurative mumps prevention
Acute suppurative parotitis is mainly a secondary disease, and its prevention is better than treatment. Correct and effective preventive and therapeutic measures can effectively prevent it.
Complication
Acute suppurative mumps complications Complications
In patients with poor general condition, acute infection can spread to the adjacent tissue space, and the clinical features of cellulitis showing the corresponding gap, the abscess can penetrate the parotid fascia and adjacent tissues in the late stage of the disease, and the external auditory canal can be broken. A subcutaneous abscess can also be formed in the posterior or mandibular angle region.
Symptom
Acute suppurative sputum gland symptoms common symptoms suppurative mumps parotid swelling swelling leukocytosis high fever abscess purulent secretions chills fever cellulitis
History
There may be systemic infections or fevers caused by infectious diseases, fasting after major surgery, dehydration, or a history of chronic wasting diseases, as well as systemic and parotid manifestations of acute infection.
2. Clinical manifestations
(1) Unilateral or simultaneous bilateral or sequential acute parotid swelling, pain or persistent jumping pain, limited mouth opening, systemic fever and discomfort.
(2) The local lesions are characterized by swelling of the parotid gland with the earlobe as the center, redness of the skin, increased skin temperature, and obvious tenderness. Because the parotid gland is dense, the sputum is hard.
(3) The mouth of the parotid gland is red, swollen, and secreted. When the rib gland is squeezed in the later stage of the disease, there may be a pale yellow thicker purulent discharge.
(4) Because the glandular gland is lobulated, the abscess can be multifocal after formation, that is, multiple scattered abscesses, and the rib fascia is tough, so even if there is abscess formation, it is difficult to sway and fluctuate ( The clinical diagnosis is mainly based on the course of the disease, systemic toxic reaction and local puncture, and the pus is taken out to confirm the diagnosis).
(5) Patients with poor general condition, the acute phase infection can spread to the adjacent tissue gap, and the clinical signs of cellulitis showing the corresponding gap, the abscess swollen the parotid fascia and adjacent tissue in the late stage of the disease, can be broken by the external auditory canal Overflowing pus can also form a subcutaneous abscess in the posterior or mandibular angle.
Sudden onset, most patients have high fever, chills, general malaise, leukocytosis and other systemic symptoms, a small number of patients due to the body's condition failure, the above systemic response may not be obvious.
Acute suppurative mumps occurs on one side, the ipsilateral parotid gland area is red and swollen, the mandibular posterior recess disappears, the earlobe is upturned, because the parotid gland is dense, the swelling is restrained, and the internal pressure is increased, so the pain is severe and the tenderness is obvious. The degree of mouth is limited, the affected side of the parotid duct is red and swollen, and there is purulent discharge. Due to the separation of the fascia, the abscess is often multiple, scattered small pus, so there is no typical fluctuation in the early stage.
Attention should be paid to the identification of mumps in the diagnosis. The latter is an infectious disease caused by the virus. It is more common in children. It has a history of contact infection, often bilateral, no purulent discharge at the opening of the parotid duct, and the total number of white blood cells is not High, the proportion of lymphocytes in the classification increased.
Examine
Examination of acute suppurative parotitis
The total number of white blood cells in the peripheral blood increased, the proportion of neutral multinucleated white blood cells increased significantly, and the left nucleus shifted, and poisonous granules may appear. However, acute suppurative mumps should not be used for parotid angiography to prevent the spread of infection, and the biochemical detection of saliva does not help diagnosis. .
Diagnosis
Diagnosis and differentiation of acute suppurative parotitis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
1. Mumps occurs mostly in children, with a history of epidemiological exposure, mostly bilateral parotid gland involvement, parotid gland enlargement, but the pain is mild, no redness and swelling of the catheter, saliva secretion clear and no pus, peripheral white blood cells The total number does not increase, but the proportion of lymphocytes increases, the abscess does not form abscess, and it usually heals after 7 to 10 days.
2. The gavage muscle infection is mainly odontogenic infection, which is characterized by swelling of the following jaw angle, tenderness, and limited mouth opening. However, there is no redness and swelling in the mouth of the parotid gland, and the secretion is clear, and the formation of abscess can be deeply fluid.
3. Parotid gland lymphadenitis, also known as pseudomumpy mumps, manifested as regional parotid swelling and pain, the lesion and the parotid anatomy are inconsistent, the parotid duct is not red and swollen, saliva secretion is clear.
