A patient with acute suppurative parotitis will usually present with signs and symptoms of acute inflammation in the parotid gland with drainage along the parotid duct.
Clinical features:
(1) Rapid onset of parotid swelling, which may unilateral or bilateral.
(2) The submandibular glands are usually not involved.
(3) Severe pain is present.
(4) The gland is firm and tender on palpation.
(5) Pus can be seen exiting from the orifice of the parotid duct (opposite the crown of the second upper molar tooth).
(6) Trismus may develop.
(7) Systemic toxicity with fever, leukocytosis, general malaise and anorexia may be present, especially with bacteremia.
(8) Gram stain and culture of the pus show bacteria.
The syndrome needs to be distinguished from recurrent parotitis, with intermittent episodes of acute parotitis over months and years.
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