A parotid abscess is a buildup of pus and infected material in the parotid gland, the largest of the salivary glands surrounding the jaw. This condition most commonly develops as a consequence of poor oral care, usually when people are recovering from a medical condition and are less capable of following a basic oral hygiene routine. Treatment usually involves drainage, medications to treat infection, and monitoring for signs of recurrence.
Symptoms of a parotid abscess include significant pain and swelling of one or both parotid glands. The area behind the jaw can feel tight and hot, and the skin may be red and shiny. A doctor must conduct a careful physical examination to rule out conditions with similar symptoms, like mumps. Examination of the mouth may also show leakage of pus from the parotid gland into the oral cavity and the patient may have foul-smelling breath as a result of the infection.
Draining the abscess is the recommended treatment, to remove the pus and then flush out the parotid gland to remove any remaining infectious material. It may be necessary to leave a drain in place temporarily to allow any additional fluid to drain freely and easily. The patient should experience immediate relief after the pus has been expressed, as the intense pressure associated with the buildup will ease off. Medications can be provided to reduce inflammation and treat infection, if bacteria or viruses appear to be involved.
As the patient recovers, drains can be removed and medications can be tapered off. Patients may also be provided with advice on modifying oral care to prevent another parotid abscess in the future. More extensive treatment may be needed if the infection was left untreated for an extended period of time, as it may have penetrated into surrounding tissues, leading to tissue death. In this case, surgery may be required to remove the dead tissue, irrigate the area, and repair any structures damaged by the parotid abscess.
It is advisable to remain alert to pain and swelling in the face such as that caused by a parotid abscess. Infections in and around the face can be dangerous, as they may put pressure on facial nerves, causing neurological problems, and they can also potentially enter the skull, causing brain infections. Infections in the brain may potentially cause permanent cognitive impairments as a result of damage to key areas of the brain, a highly undesirable complication of facial infections.