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ORIGINAL ARTICLE

Parotid abscess: 15-year experience at a tertiary care referral center in Taiwan


1 Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
2 Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center; Graduate Institute of Clinical Medicine and Department of Otolaryngology, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan
3 Department of Pediatrics, Tri-Service General Hospital; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
4 Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
5 Department of Nursing, Tri-Service General Hospital and school of Nursing, National Defense Medical Center, Taipei, Taiwan
6 Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

Correspondence Address:
Jih-Chin Lee,
Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Cheng-Kung Road Section 2, Taipei 114
Taiwan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmedsci.jmedsci_15_19

Background: Parotid abscess is an uncommon condition, but it can cause potentially lethal systemic infections. The aim of this study was to analyze cases with parotid abscess during 15-year period and further determine the optimal diagnostic and therapeutic modalities at a tertiary medical center in Taiwan. Patients and Methods: Nineteen patients diagnosed with parotid abscess were retrospectively analyzed from November 2002 to October 2017. Patients' clinical symptoms, etiology, diagnostic methods, bacteriology, and antibiotic and surgical treatment were evaluated. Results: Among 19 patients diagnosed with parotid abscess, 12 were male and 7 were female. Their diagnostic ages ranged from 25 to 88 years (mean 55.5 years). The most common symptoms at initial presentation were painful swelling of the intra-auricular region and fever. Typical etiologies were odontogenic infections or poor oral hygiene. Thirteen out of 18 patients with drainage of abscess showed positive finding of bacterial cultures, and the most common pathogen was Klebsiella pneumoniae in six patients. One patient received intravenous antibiotics alone but eventually died of sepsis. In addition to antibiotic treatment, the other 18 patients underwent a combination of antibiotic treatment and drainage of abscess. Among them, 14 patients received surgical drainage and 4 patients received ultrasound-guided needle aspiration of abscess. After drainage, all had complete resolution of disease without recurrence or sequelae during at least 1 year of follow-up. Conclusions: This study highlights that K. pneumonia is an important pathogen of parotid abscess in consideration of the rapidly increasing cases of diabetes mellitus in Taiwan. In addition to early diagnosis, parotid abscess should be managed with broad-spectrum antibiotics, adequate hydration, and appropriate drainage to prevent unwanted morbidity and mortality.


 

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