Neonatal Suppurative Parotitis

Description and Etiology

Neonatal suppurative parotitis (NSP), also known as acute suppurative parotitis, is a rare
condition in the neonate often attributable to infection by S. aureus or other Gram-positive
cocci, and Gram-negative bacilli or anaerobic bacteria. Several recent reports have also
implicated a MRSA in cases of NSP.
Clinical Presentation
NSP may affect infants between the ages of 24 weeks. Presentation includes a swelling of
the affected gland or glands with overlying erythema and may be accompanied by systemic
symptoms and signs including fever, poor oral intake, and irritability.
Diagnosis
Diagnosis of NSP is reliant on the presence of parotid swelling, which may be unilateral or
bilateral, and expression of a purulent exudate from Stensens duct in which pathogenic
bacteria are identified on culture. Diagnosis is aided by ultrasound examination, which may
show an enlarged gland and hypoechoic areas characteristic of parotitis. Ultrasound may also
help to determine whether there is an additional glandular mass or abscess. The risk factors
include dehydration, male gender, low birth weight, immune suppression, ductal obstruction,
oral trauma, and structural abnormalities of the parotid gland.
Treatment
NSP is amenable to treatment by antibiotics with supportive therapy such as adequate
hydration. However, in the event of intraglandular abscess, surgical drainage may be
necessary. Antimicrobial therapy is based on culture and sensitivity assays of the expressed
suppurative fluid. Complications reported with NSP have included facial palsy, recurrent
infection, bacteremia, and sepsis and respiratory distress. Although potential morality has
been associated with NSP, no deaths have been reported in the English-language literature
since 1970 possibly due to improvement in antibiotic therapy.

Neonatal Suppurative Parotitis

Description and Etiology
Neonatal supuratif parotitis (NSP), juga dikenal sebagai parotitis supuratif akut, adalah suatu
kondisi langka di neonatus sering disebabkan infeksi oleh S. aureus atau kokus Gram-positif
lainnya, dan basil atau bakteri anaerob gram negatif.
Presentasi klinis
NSP dapat mempengaruhi bayi antara usia 2-4 minggu. Adanya pembengkakan kelenjar yang
terkena atau kelenjar dengan eritema atasnya dan bisa disertai dengan gejala sistemik dan
tanda-tanda termasuk demam, asupan mulut yang buruk, dan mudah tersinggung.
Diagnosa
Diagnosis NSP sangat bergantung adanya pembengkakan parotis, yang mungkin unilateral
atau bilateral, dan ekspresi dari eksudat nanah dari duktus Stensen di mana bakteri patogen
diidentifikasi pada budaya. Diagnosis dibantu dengan pemeriksaan USG, yang mungkin
menunjukkan kelenjar membesar dan daerah hypoechoic ciri khas dari parotitis. USG juga
dapat membantu untuk menentukan apakah ada massa kelenjar tambahan atau abses. Faktor
risiko termasuk dehidrasi, jenis kelamin laki-laki, berat badan lahir rendah, penekanan
kekebalan, obstruksi duktus, trauma mulut, dan kelainan struktural dari kelenjar parotis.
Pengobatan
Pengobatan NSP dengan antibiotik dengan terapi suportif. Namun, dalam hal abses
intraglandular, drainase bedah mungkin diperlukan. terapi antimikroba berdasarkan kultur
dan sensitivitas tes cairan supuratif diungkapkan. Komplikasi NSP telah disertakan asimatri
wajah, infeksi berulang, bakteremia, dan sepsis dan gangguan pernapasan. Meskipun potensi
moralitas telah dikaitkan dengan NSP, tidak ada kematian telah dilaporkan dalam literatur
sejak tahun 1970 mungkin karena perbaikan dalam terapi antibiotik.