Acute bacterial (suppurative) parotitis is charactherized by painful swelling and tenderness of the entire parotid gland. The skin overlying the gland is red and hot. In addition, there is referred earache, fever and leukocytosis. Pus can be expressed from the opening of Stensen's duct. Frequently, there is abscess formation and sepsis, especially, in elderly, debilitated patients with dehydration and poor oral hygiene. (See Kussmaul's Disease below)
Occasionally, an abscess forms in the gland and ruptures through a crater in the skin.
Kussmaul's Disease (Sialodochitis Fibrinosa)
This condition designates acute parotid or submaxillary gland swelling secondary to a mucus or fibrinous plug. It occurs in dehydrated and debilitated patients who have a decreased salivary flow. Upon massage of the gland, debris may be expressed from the duct, followed by a flow of turbid saliva and a decrease in the size of the gland. This condition may lead to acute suppurative parotitis and ultimately, chronic sialadenitis.