chronic suppurative mumps
Introduction
Introduction to chronic suppurative mumps Chronic suppurative parotitis (chronic recurrent parotitis), also known as chronic spotted mumps, chronic recurrent mumps, is the most common parotid inflammation, which can occur on one side or on both sides. Adults and children have significantly different outcomes. The patient often does not know the time of onset, and often sees out because of repeated swelling of the parotid gland. Often double-sided. The onset of swelling is sometimes associated with eating and is accompanied by mild pain, which is caused by increased salivation and thickening of the saliva during eating and obstruction of discharge. In many cases, there is no clear relationship between swelling of the parotid gland and eating. In the morning, the glandular gland is swollen. After a little massage, there is a "salty" liquid that overflows from the catheter, and the part is loose. basic knowledge The proportion of illness: 0.030% Susceptible people: no special people Mode of infection: contagious Complications: swelling
Cause
Causes of chronic suppurative mumps
Saliva stasis (35%):
The cause of chronic recurrent mumps is not well understood, and it is generally considered that saliva secretion is reduced and stasis is an important factor. After the onset of severe acute parotid inflammation, the mucous membrane of the epithelium is metaplasia, and the mucus component in the saliva is increased, which is one of the factors causing salivation.
Parotid duct stenosis (35%):
Intra-glandular stones, catheter stenosis caused by traumatic inflammation, and the main catheter is too thin, etc., can cause the distal part of the obstruction to expand and cause salivation, which is called obstructive mumps. The cause of recurrent mumps in the parotid gland is considered to be longer, narrower, and more likely to cause salivation.
Prevention
Chronic suppurative parotitis prevention
Because the disease occurs, the mumps virus invades the oral mucosa and the nasal mucosa through the saliva droplets of the patient to produce and viremia. After the disease enters the bloodstream, viremia is formed. Therefore, during the epidemic, do not take the child to a movie theater with a large population. Go to public places such as the market. Healthy children must not go to contact with sick children, and the room should be open to the window.
If the diagnosis is mumps, it will be isolated, usually for three weeks, because the mumps virus is extremely sensitive to ultraviolet light, it can be killed after half a minute of irradiation, so the patient's clothes and bedding should be disinfected daily. After the illness, you should rest in bed, eat light, and gargle with 2% light salt water every day. Oral plate Langen granules, external application of "Ruyi Golden Powder" in the swollen crotch, can also take "antiviral oral liquid" high fever must be added antipyretics.
Complication
Chronic suppurative mumps complications Complications swelling
The medical history is long, recurrent, the symptoms are light and heavy, and the swelling of the eating is obvious, but the swollen parotid gland does not continue to grow.
Symptom
Chronic suppurative parotid symptoms symptoms Common symptoms of parotid swelling and swelling
The parotid area is swollen, and sometimes a thick and salty liquid flows out from the mouth of the parotid gland, and the pain is relieved or even disappeared. The persistent parotid area is painful, uncomfortable, saliva secretion is reduced, dry mouth, bad breath, and the like. Eating or seeing food, especially acidic foods, increases saliva secretion, obstruction of catheter discharge, that is, aggravation of pain and swelling in the parotid gland, and the symptoms gradually disappear after stopping, generally without obvious systemic symptoms.
Examine
Examination of chronic suppurative parotitis
Parotid angiography, X plain film. Before the angiography, it is necessary to take a normal X-ray film to exclude the presence of stones. The angiography is characterized by partial narrowing of the catheter system, partial expansion like a sausage-like change; the glandular part is expanded by a spotted distal catheter.
Parotid gland angiography: Injecting 1 to 2 ml of iodized oil into the parotid gland, sterilizing the cotton ball to compress the parotid tube, taking the X phase of the filling phase, taking out the cotton ball, containing vinegar for 5 min, and then taking the X phase of the empty phase.
Diagnosis
Diagnosis and differentiation of chronic suppurative parotitis
diagnosis
Mainly based on clinical manifestations and parotid angiography, it is necessary to take normal X-ray film before angiography, which can exclude the presence of stones. The angiography shows partial stenosis of the catheter system, and some of the expansion is like a sausage-like change; the gland part is spotted with a terminal catheter. Therefore, the disease is called chronic punctate parotitis in the literature.
The parotid angiographic manifestations of chronic recurrent mumps and Sjgren syndrome are now known as autoimmune diseases, but the relationship and difference between the two are still not very clear. The histopathology is different: chronic recurrent mumps Acinar atrophy, or even disappear, replaced by hyperplastic fibrous tissue, glandular duct hyperplasia and mucus cell metaplasia, peripheral and interstitial chronic inflammatory cell infiltration, and Sjgren syndrome mainly manifested as benign lymphoid epithelial lesions.
The patient often does not know the onset time, and often sees the doctor because of repeated swelling of the parotid gland. It is often bilateral. The swelling is sometimes related to eating and accompanied by mild pain. This is because saliva secretion increases and is thick when eating, and discharge is blocked. As a result, in many cases, there is no clear relationship between swelling of the parotid gland and eating. In the morning, the glandular gland is swollen. After a little massage, there is a "salty" liquid that overflows from the catheter, and the part is loose.
Clinical examination of the parotid gland is slightly swollen or inconspicuous, accompanied by acute infection, the skin color is slightly red, generally normal, the catheter mouth may have a slight redness, the pressure gland can flow out of the tube mouth turbid "snowflake-like" "Saliva, or viscous egg white-like saliva, even mucous emboli instead of saliva, the long-term disease of the gland is hard and tough, and the parotid duct is thick and hard.
Chronic recurrent mumps generally has no systemic symptoms.
Recurrent mumps occurs in children different from adults. The age of onset can occur from infants to 15 years old. It is most common for boys around 5 years old. The interval is several weeks or months. The younger the age, the interval is. The time is shorter; as the age increases, the longer the interval, or even one to two years of swelling, gradually self-healing after puberty, very few cases continue to attack, swelling can be very sudden, unilateral or bilateral, from parotid angiography Observed, many children showed bilateral sialectasis at the distal end of the parotid duct, but often only one side of the swelling, due to children with recurrent mumps have a tendency to self-healing, many are considered to be due to congenital hypoplasia Because many studies have reported that children diagnosed with recurrent mumps in childhood, and then performed parotid angiography in adulthood, the original point-like dilatation disappeared, but the real cause is still not clear.
Differential diagnosis
Children with recurrent mumps must be distinguished from mumps, with a history of exposure to mumps, often occurring bilaterally with fever, and parotid duct secretion is normal.
The parotid angiographic manifestations of chronic recurrent mumps and Sjgren syndrome are now known as autoimmune diseases, but the relationship and difference between the two are still not very clear. The histopathology is different: chronic recurrent mumps Acinar atrophy, or even disappear, replaced by hyperplastic fibrous tissue, glandular duct hyperplasia and mucus cell metaplasia, peripheral and interstitial chronic inflammatory cell infiltration, and Sjgren syndrome mainly manifested as benign lymphoid epithelial lesions.
