suppurative mumps
Introduction
Introduction to suppurative mumps Suppurative mumps, also known as spotted mumps and chronic recurrent mumps, is the most common inflammation of the parotid gland, which can occur on one side or on both sides. It is an ascending infection from the mouth, usually caused by Staphylococcus aureus that can affect the mouth of the parotid gland. Typical infections occur in elderly or chronic patients who have a dry mouth due to low intake or taking anticholinergic drugs, as well as patients after general anesthesia, with fever, chills and unilateral parotid pain and swelling; the parotid gland is hard and It is tender and has erythema and edema on the skin above it. Pressing the parotid gland causes the pus to flow out of the parotid gland. After smear, a pile of Gram-positive cocci is often seen. basic knowledge The proportion of illness: 0.003% Susceptible people: no specific population Mode of infection: non-infectious Complications: male infertility
Cause
Causes of suppurative mumps
Infection (30%):
Caused by purulent pathogens, the most common pathogen is Staphylococcus aureus. Most of them are complicated by some patients with serious diseases (such as acute infectious diseases) or after major surgery.
Low immunity (25%):
Serious illness and consumptive diseases, such as patients with acute infectious diseases or patients after thoracic and abdominal surgery, the body's resistance is reduced, the immunity of the whole body and mouth is weakened, salivary secretion is dysfunctional, and pathogenic bacteria are retrograde into the gland through the parotid duct. Acute suppurative mumps occurs.
Trauma (20%):
The expansion of trauma or surrounding tissue inflammation, vermiculite, scar contracture, etc. affect saliva exclusion, can also cause the disease.
Other factors (15%):
Such as cold stimulation.
Prevention
Suppurative mumps prevention
Suppurative mumps is mainly retrograde infection. Therefore, keeping the mouth clean and hygienic is an important part of preventing the disease. Brush your teeth every morning and evening, rinse your mouth after meals, and if necessary, do periodontal scaling. Some patients with weak constitution, long-term bed rest, high fever or fasting can often have dehydration, and should strengthen oral care (such as careful brushing, common chlorhexidine solution, etc.), maintain body fluid balance, strengthen nutrition and anti-infective treatment. After major surgery, especially in abdominal surgery, the parotid gland may have reduced or stopped reflex function. The doctor should think of the possibility of acute suppurative mumps in the patient, and strengthen the pre- and post-operative treatment to maintain the patient's normal intake and body fluid balance, correct the body's water shortage and electrolyte imbalance, and if necessary, a small amount of fresh blood to enhance the body's resistance. Taking the above preventive measures can effectively prevent the occurrence of acute suppurative mumps.
Complication
Complications of suppurative mumps Complications, male infertility, high fever in children
1, a long history, repeated attacks, mild and heavy symptoms, eating swelling is obvious, but the swelling of the parotid gland does not continue to grow.
2, patients with poor general condition, acute infection can spread to the adjacent tissue gap, and the clinical features of the 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.
Symptom
Symptoms of purulent parotid gland Common symptoms Facial pain Leukocytosis Intermittent chills Pulse speed
The initial symptoms of suppurative mumps are mainly pain, which gradually causes swelling of the parotid gland with the earlobe as the center. The mouth of the parotid gland can be red and swollen, and the mouth of the parotid gland with compression and swelling can discharge purulent or inflammatory secretions. If the infection is not treated in time, the glandular tissue will be necrotic, spread to the entire parotid gland tissue and spread to surrounding tissues. The systemic response was not obvious at the beginning of inflammation. Exacerbations can cause high fever, sometimes up to 40 ° C, white blood cells, especially neutrophils. The systemic response depends mainly on the virulence of the bacteria and the condition of the patient's body.
Examine
Examination of suppurative mumps
1, 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.
2, the total number of white blood cells increased in the surrounding blood, the proportion of neutral multinucleated white blood cells increased significantly, the left side of the nuclear shift, poisoning particles may appear, but acute suppurative mumps should not be used for parotid angiography, so as not to promote the spread of infection, and the biochemical detection of saliva is also helpless. For diagnosis.
Diagnosis
Diagnosis and differentiation of suppurative parotitis
diagnosis
Diagnosis can be performed based on clinical manifestations and examinations.
Differential diagnosis
1. Epidemic mumps: occurs in children, has a history of epidemiological exposure, mostly bilateral parotid gland involvement, parotid gland enlargement, but the pain is light, no redness in the catheter mouth, saliva secretion clear and no pus, peripheral blood The total number of white blood cells does not increase, but the proportion of lymphocytes increases, and the abscess does not form abscesses, which usually heal after 7 to 10 days.
2. Gummy muscle interstitial infection: mainly odontogenic infection, manifested as swelling of the following jaw angle, tenderness, limited mouth opening, but no obvious swelling of the parotid duct, clear secretion, abscess formation can be deep fluid.
3. Parotid gland lymphadenitis: also known as pseudo-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.
