Acute viral parotitis

5-year-old girl broughtBrought to the E.R.ER with painful swelling of the right side of her face. The mother also complained aboutmentioned fever (38.6ºC) and dry cough in the last 48 hours.

The parotid glands are small exocrine glands located superficial and around the ramus of the jaw, which are rarely affected by diseases of any kind. Occasionally, however, the radiologist is asked to examine them (usually in the setting of pain or swelling).

In children, the main cause for painful enlargement of the parotid is an entity called viral parotitis, usually caused by Mumps. This paramyxoviral disease is spread by droplets or direct contact, and its prevalence has drastically decreased since vaccination started in the 1970's, being more common in underdeveloped countries. The children may present with viral symptoms like fever, dry cough, and body pain, but a dominant feature may be the viral parotitis, which appears in theon US as heterogenicity of the parenchyma with augmented vascularizationhyperemia.

Differential diagnosis of an enlarged parotid gland includes acute bacterial parotitis, HIV parotitis, parotitis related to tuberculosis, Mickulicz disease, Sjögren's syndrome disease, sialolithiasis, chronic recurrent parotitis, sarcoidosis, and benign tumors and malignancymalignant tumors.

In this US image of theEnlarged, heterogeneous right parotid gland it is possible to see a markedly heterogeneous pattern of the gland, with severalmany hypoechoic round imagesfoci permeating its parenchyma. These round imagesfoci proved to be prominent vessels on the color Doppler ultrasound. An image of theNormal-appearing left parotid gland of the same patient is available for comparison of size, echogenicity and vascularization.