Recurrent parotitis, also known as juvenile recurrent parotitis is defined as recurrent parotid inflammation, generally associated with non-obstructive sialectasis of the parotid gland(1). The etiology is not clear and in most cases, symptoms resolve spontaneously after puberty. A 7-year-old boy is presented here who had eight episodes of recurrent parotid swelling.

A 7-year-old boy presented with acute swelling of 72 hour duration of his left parotid gland. The child was afebrile and there was an enlargement and tenderness in his left parotid gland. Pressure over the gland did not cause any purulent discharge from the parotid duct. There was no sign of xerophtalmia and xerostomia. Over the previous years, he had 7 episodes of left parotid swelling. There was no family history of recurrent parotid swelling. The patient’s blood count, erythrocyte sedimentation rate and serum immunglobulin levels were in normal limits. HIV serology was negative. Antibodies including anti-Ro and anti-La for Sjögren’s syndrome were not detected. Longitudinal paroti sonogram demonstrated heterogenous internal echogenicity and nodular hypoechoic areas reflecting sialectasis in the left paroti gland. A diagnosis of recurrent parotitis was made and the patient was advised to take high fluid intake especially in the course of an upper respiratory tract infection.

Recurrent parotitis is an idiopathic condition which usually begins between 3 and 6 years of age(1). The disease favors males and the number of attacks changes from one to five per year but there are patients who have 20 or more attacks per year(2). In 80-90% of the patients, the symptoms spontaneously resolve by puberty(1,3). Although most of the cases have the idiopathic type of the disease, reccurent parotitis might be the first presenting symptom of an underlying common variable immunodeficiency, HIV infection and primary Sjögren’s syndrome. Reid, et al. reported an autosomal dominant inheritance in a family and this suggests that, at least in some cases genetic factors may be applicated in juvenile recurrent parotitis (4). Sialectasis was previously diagnosed by sialography, but ultrasound superceded this technique. The effects of antibiotics on the natural course of the disease is a dilemma.

In conclusion, although recurrent parotitis is rare in childhood, but it is a fearing condition for the families. Investigation for an immunodeficiency, Sjögren’s syndrome, HIV infection and family history is essential in these cases. An ultrasound of the glands is necessary for diagnosis and it can also be used to exclude a solid mass or a stone. The use of antibiotics is controversial and preventing dehydration is very important. Since most of the cases resolve by puberty, reassurance of the family about the benign course of disease is enough.

Uluç YIS,
Nurettin ÜNAL,
Department of Pediatrics,
Dokuz Eylül University,
Faculty of Medicine,
Izmir, Turkey.
E-mail: [email protected]

1. Geteraud A, Lindvall AM, Nylen O. Follow up study of recurrent parotitis in children. Ann Otol Rhinol Laryngol 1988; 97: 341-346.

2. Ericson S, Zetterlund B, Ohman J. Recurrent parotitis and sialectasis in childhood. Clinical, radiologic, immunologic, bacteriologic and histologic study. Ann Otol Rhinol Laryngol 1991; 100:527-35.

3. Chitre VV, Premchandra DJ. Recurrent parotitis. Arch Dis Child 1997; 77:359-363.

4. Reid E, Douglas F, Crow Y, Hollman A, Gibson J. Autosomal dominant juvenile recurrent parotitis. J Med Genet 1988; 35:417-419.