PNR Neck 5

History

14 yo M with sepsis, left facial swelling

Major Findings

Enlarged and hyperenhancing left parotid gland, consistent with acute parotitis
Cellulitis and myositis of left sternocleidomastoid muscle
Reactive cervical lymphadenopathy

Teaching Points

Acute parotitis is often due to bacterial infection (sialadenitis) but can also seen in cat-scratch disease, HIV, or other diseases. With bilateral parotitis in an unvaccinated child, think of mumps.

Pertinent negatives for this case include:

No abscess
No obstructing stone (sialolithiasis)

Article on deep neck space infections:

Accession: CL1029

Study description: Neck^ST_NECK_OVER_55_KG (Adult)