INVESTIGATORY

PROJECT

NAME: DEBDEEP DAN

CLASS: XII Sci. A
ROLL:
SUBJECT: BIOLOGY (044)

TOPIC:
CASE STUDY OF A PATIENT
AND THE DISEASE

D. A. V PUBLIC SCHOOL
MIDNAPORE

Debdeep Dan
[COMPANY NAME]
 INVESTIGATORY PROJECT

ACKNOWLEDGEMENT
I would like to express my special thanks of gratitude to
my biology teacher Mr. Sankha Chakraborty as well as
our Principal Mr. Banamali Biswal who gave me the
golden opportunity to do this project on the topic
“Parotitis” and also for their guidance and
encouragement in carrying out this project work. This
project also helped me in gaining a lot of knowledge as I
did research and I came to know about so many things. I
am really thankful to them.
Secondly, I would like to thank my parents and friends
who helped me a lot in finalizing this project within
limited time frame.

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CERTIFICATE

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INDEX
TOPICS Page No.
 Disease Analysis
1) Introduction 4
2) Epidemiology 5-6
3) Causes 7-13
4) Pathogenesis 12-15
5) Complications 16-17
6) Signs & Symptoms 18-20
7) Prevention 21-22
8) Treatment 23-25

 Methodology
1) Interaction with Doctor 27-29
2) Interaction with Patient 30-31

 Case Study
1) Biodata 33
2) Prescriptions 34-36
3) Lab Reports 37-39

 Result Analysis 40

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INTRODUCTION

This investigatory project is based on Right sided

Parotitis/Mumps experienced by patient Debdeep Dan from
August 18 to September 4th 2019.
This project deals with the complete profile of the disease, it’s
causes, prevention and identification techniques.
The patient profile deals with the complications faced,
diagnosis, treatment and medication.

Patient: Debdeep Dan

Disease: Right Sided Parotitis/ Mumps
Doctors Consulted – (a) Dr. Siddhartha Ghosh
(b) Dr. Puspendu Bikas Mandal
(c) Dr. Santosh Kumar Dey

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Epidemiology
History: Parotitis was described by Hippocrates in the 5th
century BCE. In 1934, Claud Johnson and Ernest Goodpasture
showed that mumps could be transmitted from infected patients
to rhesus monkeys and demonstrated that mumps was caused
by a filterable agent present in saliva. This agent was shown to
be a virus in 1935.
Mumps was one of the most common causes of aseptic
meningitis and sensorineural hearing loss in childhood in the
United States until the introduction of a vaccine in 1967.

Vaccine - In 1971, mumps vaccine waslicensed in the United

States as a combined measles, mumps, and rubella (MMR)
vaccine.

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In 2005, a combination measles, mumps, rubella, and varicella

(MMRV)vaccine were licensed.

During World War I, only influenza and gonorrhea were more

common than mumps as causes of hospitalization among
soldiers. A successful 2-dose vaccination program in the
United States led to a greater than 99% reduction in the number
of mumps cases reported annually. However, starting in 2006,
there has been an increase in mumps cases and outbreaks,
particularly in close-contact settings, with many occurring
among fully vaccinated persons.

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Causes
Mumps Virus – A paramyxovirus in the same group as
parainfluenza and Newcastle disease viruses, which produce
antibodies that cross-react with mumps virus. The virus has a
single-stranded RNA genome.
The virus can be isolated or propagated in cultures of various
human and monkey tissues and in embryonated eggs. It has
been recovered from the saliva, cerebrospinal fluid, urine,
blood, semen, breastmilk, and infected tissues of patients with
mumps.
Mumps virus is rapidly inactivated by formalin, ether,
chloroform, heat, and ultraviolet light.
Dehydration: This is a common, non-infectious cause of
parotitis. It may occur in elderly or after surgery.
Infectious Parotitis
Acute bacterial parotitis: is most often caused by a bacterial
infection of but may be caused by
any commensal bacteria. Parotitis presents as swelling at the
angle of the jaw. Bacterial parotitis presents as a unilateral
swelling, where the gland is swollen and tender and usually
produces pus at the Stensen's duct. This pus is usually sampled
and the bacteria within are identified. Common causative
bacteria are Staphylococcus aureus, Streptococcus pyogenes
and E. Coli. It is associated with poor oral hygiene; oral
infections and decreased saliva production. Symptoms include
fever, dehydration, chills, fast heartbeat and breathing if the
infection is causing Sepsis. Medications such
as antihistamines and diuretics can be predisposing factors.
Treatment–Antibiotics
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Extrapulmonary Tuberculosis
The mycobacterium that cause tuberculosis can also cause
parotid infection. Parotid swelling can be an uncommon
symptom of extrapulmonary tuberculosis (TB outside of the
lungs). The usual symptoms are a cough, fever, weight loss,
shortness of breath, chest pain, tiredness and chills. This is
caused by the bacteria Myobacterium Tuberculosis. TB can
also affect the heart, thyroid and adrenal glands but the main
site of infection is the lungs. Risk factors are chronic alcohol
consumption, diabetes, long term steroid use, HIV infection
and kidney failure. Those infected tend to have enlarged,
nontender, but moderately painful glands. The diagnosis is
made by typical chest radiograph findings, cultures, or
histologic diagnosis after the gland has been removed. When
diagnosed and treated with antitubercular medications, the
gland may return to normal in 1–3 months.

Acute Viral Parotitis (Mumps)

The most common viral cause of parotitis is mumps.
Routine vaccinations have dropped the incidence of mumps to
a very low level. Mumps resolves on its own in about ten days.
A viral infection caused by Paramyxovirus, a single-stranded
RNA virus. Common symptoms include fever, headache and
bilateral or unilateral parotitis (swelling of the parotid gland on
one or both sides of the face). The parotid gland is usually
swollen and tender. Parotid swelling usually occurs 16–18 days
after exposure to the virus. Treatment includes isolation and
therefore prevention of spread of the disease and supportive
measures such as hot or cold packs. Mumps usually resolves
itself and can be prevented by vaccination.

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HIV Parotitis
Generalized lymphadenopathy has long been associated
with HIV, but the localized enlargement of the parotid gland is
less well known. HIV-associated salivary gland disease can
involve many diseases but often presents as enlargement of the
parotid gland and a dry mouth. Causes have not been
specifically identified but the most likely are viral opportunists
and autoimmune responses.
Viruses Linked – Hepatitis C, Cytomegalovirus,
Paramyxovirus, Influenza A and Adenovirus.
Treatment – Anti-Retoviral Therapy

Disseminated Histoplasmosis
During a large urban Disseminated Histoplasmosis outbreak
(est. 100,000 victims) in Indianapolis from 1978–1979,
manifestations included parotitis.

Autoimmune Causes
These are also collectively known as chronic punctate parotitis
or chronic autoimmune parotitis.
Sjogren’sSyndrome:-
Chronic inflammation of the salivary glands may also be an
autoimmune disease known as Sjogren’s syndrome. The
disease most commonly appears in people aged 40–60 years,
but it may affect small children. In Sjogren’s syndrome, the
prevalence of parotitis in women versus men is approximately
9:1. The involved parotid gland is enlarged and tender at times.
The cause is unknown. The syndrome is often characterized by
excessive dryness in the eyes, mouth, nose, vagina, and skin.
Lymphoepithelial lesion of Godwin:-
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Most frequently associated with a circumscribed tumor with the

histologic features of Sjogren’s syndrome. This designation has
also fallen out of favour.

Blockage
Blockage of the main parotid duct, or one of its branches, is
often a primary cause of acute parotitis, with further
inflammation secondary to bacterial superinfection. The
blockage may be from a salivary stone, a mucous plug, or,
more rarely, by a tumor, usually benign. Salivary stones (also
called sialolithiasis, or salivary duct calculus) are mainly made
of calcium, but do not indicate any kind of calcium
disorder. Other causes can be duct stricture (narrowing of the
duct), infection or injury. Symptoms may include recurrent
swelling, pain and aggravation during eating as this is when
saliva production is stimulated. Ductal obstruction may cause
less saliva flow, which can result in recurrent gland infections.
Stones may be diagnosed via X-ray (with a success rate of
about 80%), a computed tomography (CT) scan or medical
ultrasonography. Stones may be removed by manipulation in
the doctor's office, or, in the worst cases, by
surgery. Lithotripsy, also known as "shock wave" treatment, is
best known for its use breaking up kidney stones. Lithotripsy
can now be used on salivary stones as well. Ultrasound waves
break up the stones, and the fragments flush out of the salivary
duct.

Diseases of Uncertain Cause

Chronic Nonspecific Parotitis:-

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This term is generally used for patients in whom no definite

cause is found. Episodes may last for several days, paralleling
the time course of a bacterial or viral illness. Others may
experience episodes that last only a few hours from onset to
resolution. Some episodes may last for several weeks.
Quiescent periods between episodes last for hours, days, or
even years.
Recurrent Parotitis of childhood:-
An uncommon syndrome in which recurring episodes clinically
resembling mumps. Generally, episodes begin by age 5 years,
and virtually all patients become asymptomatic by age 10–15
years. The duration of attacks averages 3–7 days but may last
2–3 weeks in some individuals. The spectrum varies from mild
and infrequent attacks to episodes so frequent that they prevent
regular school attendance. Local heat applied to the gland,
massaging the gland from back to front, and
taking penicilin usually cure individual episodes. Treatment of
individual infections may prevent injury to the gland
parenchyma. Severe disease may be treated by parotidectomy.
Sialadenosis (Sialosis):-
In this disorder, both parotid glands may be diffusely enlarged
with only modest symptoms. Patients are aged 20–60 years at
onset, and the sexes are equally involved. The glands are soft
and non-tender. Approximately half of the patients have
endocrine disorders such as diabetes, nutritional disorders such
as pellagra or kwashiorkor, or have taken drugs such as
guanethidine, thioridazine, or isoprenaline.

Sarcoidosis :-
The lungs, skin, and lymph nodes are most often affected, but
the salivary glands are involved in approximately 10% of cases.
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Bilateral firm, smooth, and non-tender parotid enlargement is

classic. Xerostomia occasionally occurs. The Heerfordt-
Waldenstrom syndrome consists of sarcoidosis with parotid
enlargement, fever, anterior uveitis, and facial nerve palsy.
IgG4-related sialadenitis:-
This term refers to IgG4-related disease (IgG4-RD) involving
any of the major salivary glands, i.e. parotid or submandibular
glands. This is often symmetrical and is usually associated with
manifestations of IgG4-RD elsewhere in the body. IgG4-
related sialadenitis is particularly associated with involvement
of one or both of the lacrimal glands (referred to as IgG4-
related dacryo-sialadenitis).
Mikulicz's disease :-
Now considered to be a subtype of IgG4-related disease, was a
term used when (i) any two of the parotid, submandibular and
lacrimal glands were persistently and symmetrically enlarged
and (ii) other diseases that may mimic this presentation were
excluded.
Pneumoparotitis:-
Air within the ducts of the parotid gland with or without
inflammation. The duct orifice normally functions as a valve to
prevent air from entering the gland from a pressurized oral
cavity. Rarely, an incompetent valve allows insufflation of air
into the duct system. Pneumoparotitis most commonly occurs
in wind instrument players, glass blowers, and scuba divers.
Several lymph nodes reside within the parotid gland as a
superficial and deep group of nodes. These nodes may be
involved with any process that affects lymph nodes, including
bacterial, fungal, viral, and neoplastic processes. Rarely, drugs
such as iodides, phenylbutazone, thiouracil, isoproterenol,

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heavy metals, sulfisoxazole, and phenothiazines cause parotid

swelling.
Masseteric Hypertrophy :-
Masseteric Hypertrophy (enlargement of the masseter
muscle’s volume) can present as facial swelling in the parotid
gland area and may be confused with ‘true’ parotid gland
swelling. The specific cause of masseteric hypertrophy is still
unclear, but it may be related to tooth grinding or malocclusion.
Treatment options can include surgical removal of some of the
muscle and botulinum toxin type A injections.

Pathogenesis
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The virus is acquired by respiratory droplet transmission. It

replicates in the nasopharynx and regional lymph nodes.
During viremia, the virus spreads to multiple tissues, including
the meninges, salivary glands, pancreas, testes, and ovaries.
Inflammation in infected tissues leads to characteristic
symptoms of parotitis and other complications such as orchitis
and aseptic meningitis.
Incubation Period - The incubation period of mumps is usually
16 to 18 days but can range from 12 to 25 days.
Symptoms - The prodromal symptoms are nonspecific and
include myalgia, anorexia, malaise, headache, and low-grade
fever.

Mumps typically presents as parotitis (i.e., swelling of the

parotid gland) or other salivary gland swelling lasting about 5
days. Parotitis may be unilateral or bilateral, and swelling of
any combination of single or multiple salivary glands may be
present. Parotitis may first be noted as earache and tenderness
on palpation of the angle of the jaw. Emergence of contralateral
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or same side parotitis within weeks to months after apparent

recovery has been described.
Mumps infection may present only with nonspecific or
primarily respiratory symptoms or may be a subclinical
infection.
Before the introduction of the mumps vaccine, approximately
15% to 24% of infections were asymptomatic. The frequency
of asymptomatic infection in vaccinated persons is unknown,
but mumps is generally milder among vaccinated persons.
Mumps virus is the only infectious agent known to cause
epidemic parotitis. Cases of mumps reinfection have been
reported.

Complications
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Complications of mumps occur with or without parotitis or

other salivary gland swelling and generally include
i) Orchitis
ii) Oophoritis
iii) Mastitis
iv) Pancreatitis
v) Hearing loss
vi) Meningitis
Rare Symptoms
i) Nephritis
ii) Myocarditis
iii) Paralysis
iv) Seizures
v) Cranial Nerve Palsies
in mumps patients have also been reported but are rare.
Complications associated with mumps infection are usually
more common among adults than children. Vaccinated persons
are less likely to have mumps complications than unvaccinated
persons.
Orchitis is the most common complication in post-pubertal
males, occurring in approximately 30% of unvaccinated and
6% of vaccinated post-pubertal males. With mumps-associated
orchitis, there is usually abrupt onset of testicular swelling,
tenderness, nausea, vomiting, and fever. Pain and swelling may
subside in 1 week, but tenderness may last for multiple weeks.
About half of patients with mumps orchitis develop testicular
atrophy of the affected testis. While there is a theoretical risk
for sterility based on the pathogenesis of the disease, no study

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has demonstrated a risk for sterility in men with mumps orchitis

compared to those without mumps orchitis.
In the pre-vaccine era, oophoritis and mastitis had been
reported in 7% and 30%, respectively, of post-pubertal women
with mumps. Among vaccinated post-pubertal women,
oophoritis and mastitis are reported in 1% or fewer of mumps
patients. Among unvaccinated patients, clinical aseptic
meningitis occurred in up to 10%, pancreatitis in up to 4%, and
sensorineural hearing loss in up to 4%. Meningitis is usually
mild.
In the postvaccine era, among all persons infected with mumps,
reported rates of meningitis, encephalitis, pancreatitis, and
hearing loss (either transient or permanent) have all been 1% or
less.
Permanent sequelae and death are very rare in both vaccinated
and unvaccinated patients.

Signs and Symptoms

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Diagnosis
Laboratory Testing
The diagnosis of mumps is usually suspected based on clinical
presentation, in particular the presence of parotitis. However, if
mumps is suspected, laboratory testing should be performed.
Other infectious causes of parotitis that may also be tested as
part of the differential diagnosis include
i) Cytomegalovirus
ii) Parainfluenza Virus types 1 and 3
iii) Influenza A virus (most commonly H3N2)
iv) Lymphocytic Choriomeningitis Virus
v) Human Immunodeficiency Virus (HIV)
vi) Non-Tuberculous Mycobacterium.

Confirmation

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Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR)

or viral culture from buccal/oral or urine specimens. A negative
RT-PCR or viral culture in a person with clinically compatible
mumps symptoms does not rule out mumps as a diagnosis.
Acute mumps infection can be detected by the presence of
serum mumps IgM. However, this test cannot be used to
confirm a diagnosis of mumps. IgM response may be transient,
delayed, or not detected. This may be because of previous
contact with mumps virus either through vaccination or natural
infection. A negative IgM in a person with clinically
compatible mumps symptoms does not rule out mumps as a
diagnosis. False negatives are common so results should be
interpreted with caution. Collection of serum 3 to 10 days after
parotitis onset improves the ability to detect IgM.

Acute mumps infection can also be detected by a significant

rise in IgG antibody titer between acute and convalescent-phase
serum specimens, also known as IgG seroconversion.
However, this test cannot be used to confirm a diagnosis of
mumps. False positive results can occur in both unvaccinated
and vaccinated persons because assays may be affected by
other diagnostic entities that cause parotitis.
In addition, false negative results can occur in vaccinated and
unvaccinated persons. By the onset of symptoms, in someone

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who is vaccinated or had previous infection, the acute-phase

IgG may already be elevated, and therefore a 4-fold rise cannot
be detected when compared to the convalescent-phase serum
sample.
Laboratory testing can confirm the presence of mumps vaccine
virus in a recently vaccinated and potentially exposed
individual.

PREVENTION
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Adequate hydration and antimicrobial therapy are the main stay

of treatment. Antibiotics should be administered intravenously
in acute bacterial parotitis after obtaining blood
cultures. Staphylococcus aureus is the most common organism
in community-acquired parotitis and first-line antibiotic
therapy should include anti staphylococcal antibiotic
(nafcillin, oxacillin, cefazolin).

MRSA coverage should be considered if the patient has a

history of recurrent cutaneous MRSA abscesses, residence in a
nursing home with endemic MRSA, or other predisposing
condition. For health care associated parotitis, broad spectrum
antibiotics are recommended as mentioned
in . Cefoxitin, imipenem, ertapenem, the combination of a
penicillin plus beta-lactamase
(amoxicillin/clavulanate, ampicillin/sulbactam) will provide
adequate coverage. However, the presence of MRSA may
mandate the use of vancomycin, linezolid (3, 4),
or daptomycin. The presence of associated dental infection

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warrants anaerobic coverage. In penicillin allergic

patients, clindamycin is an alternative option.

Treatment should be adjusted based on culture results and

presence or absence of bacteraemia. Standard therapy is 10 to
14 days, likely longer in the presence of bacteraemia. Surgical
drainage and decompression of the gland are occasionally
required if spontaneous drainage does not occur. Therapy for
chronic parotitis should initially be conservative.
Parotidectomy may eventually be required for people with
long-standing infection. Good oral hygiene, adequate
hydration, and early therapy for bacterial infections of
the oropharynx are helpful measures for preventing acute
bacterial parotitis.

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TREATMENT
The treatment of parotitis is primarily symptomatic control
with a focus on local application of heat, gentle glandular
massage from posterior to anterior, sialagogues, and adequate
hydration. Simple anti-inflammatory analgesics, such as
acetaminophen or ibuprofen, are sufficient for discomfort. If
purulent drainage expresses during the glandular massage,
culture and sensitivities should be obtained by swab or needle
aspiration to guide proper antibiotic therapy.
Sialolithiasis, a cause of parotitis, can resolve with warm
compresses, massage, and sialagogues (sour food or lemon
candy), but occasionally requires extraction. After local
anaesthesia with topical or infiltrated lidocaine, the duct can be
dilated or filleted with scissors, then massaged to squeeze out
the stone. Extracorporeal shockwave lithotripsy, to fragment
the stone before extraction, or interventional Sia endoscopy by
otolaryngology specialists are options for refractory cases.
Parotitis that is suspected to
be secondary to human
immunodeficiency virus
(HIV) or chronic autoimmune
conditions (e.g., rheumatoid
arthritis) should focus on
treating the underlying
condition, such as anti-
retroviral therapy or steroids.

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Treatment of acute bacterial

parotitis should include
intravenous (IV) hydration,
analgesics, and 7 to 10 days of IV
antibiotics. In community-
acquired parotitis, first-line
treatment is with anti-
staphylococcal penicillin
(nafcillin, oxacillin), first-
generation (cefazolin), vancomycin, or clindamycin for
suspected methicillin-resistant S. aureus (MRSA).
For health-care-associated parotitis, use cefoxitin, ertapenem,
or ampicillin/sulbactam, with levofloxacin, clindamycin, or
piperacillin-tazobactam as alternatives. For patients at high risk
of MRSA, start with vancomycin or use linezolid or
daptomycin as alternatives. Parotitis, in case of dental
infection, should prompt the use of clindamycin or
metronidazole (anaerobic coverage) and ceftriaxone or
piperacillin-tazobactam as an alternative.

In neonates, where acute parotitis can be life-threatening,

antibiotics are usually IV gentamicin or levofloxacin and anti-
MRSA anti staphylococcal antibiotics. If clinical improvement
does not take place within 48 hours, parotidectomy may be

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necessary. The rare parotitis from extrapulmonary tuberculosis

responds well to antitubercular medications.
Consult otolaryngology early for incision and drainage for
cases of acute parotitis refractory to conservative measures of
hydration and antibiotics. Specialists might consider saline
irrigation of the duct system to remove inspissated mucus or
pus.
Treatment of HIV parotitis may include antiviral therapy, low
dose radiation, or partial parotidectomy to reduce glandular
size.
Superficial parotidectomy is usually last resort for chronic
parotitis and may involve ligation of the duct or instillation of
methylene violet. Surgery may be necessary for disfiguring
swelling, chronic autoimmune parotitis at risk for neoplastic
lymphoma, or adjacent inflammation resulting in facial nerve
paralysis.

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INTERACTION WITH DOCTOR (TRANSCRIPT)

Debdeep: Hello doctor! Thank you so much for taking time out
of your busy routine. Is it okay if I ask you a few questions
about Parotitis especially with regard to me? My mother has
telephonically informed you about this yesterday.
Doctor: Oh yes, go ahead with your questions.
Debdeep: Thank you, Doctor. Can you please tell me what you
remember about my history in this regard?
Doctor: Well so you first came to me on 28th August 2019 with
serious pain in your right parotid gland as has been identified
by previous physician.
Debdeep: Oh, I see. And what did you suspect?
Doctor: At first after examining, you I found that you were
having an infection in your parotid gland which was persistent
in your throat causing severe pain.
Debdeep: So, what suggestion did you give me?
Doctor: I asked you to get tested of his blood report and take a
USG of the parotid region and throat.
Debdeep: And what did they indicate?
Doctor: After having a thorough lookout at the reports which
came two days later, I found that you were suffering through
serious infection in your throat and very low in your Na, K and
Platelets count.
Debdeep: That’s pretty serious! And how did you then arrive at
your final diagnosis?

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Doctor: I recommended you some medications that would help

you counter sudden fevers. But the most important of all was
an increased salt diet and increased fluid intake to rehydrate the
body as I found that you had lost all your appetite.
Debdeep: I am sure that I was vaccinated against Mumps then
how could I be affected by the disease?
Doctor: There are several cases in which a vaccinated person
has also contracted this disease. This actually happens when the
tolerance of this viruses increases against these vaccines.
Debdeep: Ok fine! Is the disease even so severe?
Doctor: Yes, cases can be very much sensitive wherein a person
might need to be hospitalised in order to carry further
treatments due to excessive fluid loss and weakness.
Debdeep: Then what could be the possible precautions against
this disease?
Doctor: It doesn’t have any such precautions but one can
maintain a safe distance from a person having severe cough and
cold and must try to keep his/her surroundings clean if he/she
has a past case of the disease.
Debdeep: After going through my reports, I remembered that
2months later I again suffered from a sore throat. Do you have
any information about that?
Doctor: Oh yes, that time it wasn’t as much serious?
Debdeep: What change in treatment you brought?
Doctor: I just advised to have a regular gargle with Bitadine
and if he catches fever then he should look for a Paracetamol.

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Debdeep: I understand. Thank you again a very much Doctor,

this was very interesting and highly engaging. I learnt a lot.
Thank you so much for explaining these medical matters to me.
Doctor: You’re welcome. Glad to have helped.
Debdeep: Thanks again. Bye.

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INTERACTION WITH PATIENT (TRANSCRIPT)

Sayantani: Hello! Now I have taken your basic details, can I
ask you some more details regarding your problems?
Debdeep: Yes, sure!
Sayantani: Can you tell me regarding what your main
complaint was?
Debdeep: I used to have some vague pain in the right side of
my cheek at first?
Sayantani: And how severe was the pain?
Debdeep: Not that severe but slowly it grew.
Sayantani: Oh, and when did you go to the doctor for this?
Debdeep: I don’t remember that exactly. But I visited my first
physician 2 days after the pain started. He told me to follow
some medicines but couldn’t identify the disease at first.
Sayantani: Oh okay. So before going to the doctor was there
any home remedies or medicines that you tried?
Debdeep: Yes, a bit to suppress the pain like a Combiflam.
Sayantani: Is there anything that you felt worsened the pain?
Debdeep: No, I can’t think of anything particular.
Sayantani: Okay sure now can you tell me briefly what the
doctor told you?
Debdeep: He told me that I was suffering from right lobed
parotitis and it was an infection that might spread.

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Sayantani: Can you elaborate a bit more on what treatment

advice he gave you?
Debdeep: He said that though there is medicine but my
condition can be treatment with proper dietary routine with
some medicines to keep the infection under check.
Sayantani: And what were those?
Debdeep: A high salt diet with increased liquid intake (ORS)
with some analgesics and antipyretics.
Sayantani: So, did you follow them regularly?
Debdeep: Yes, I did. I even made sure that took adequate
amount of salt and sufficient fluid in every meal.
Sayantani: And do you feel that helped you?
Debdeep: My pain was reduced sufficiently; I gained my
appetite slowly and the infection stopped. My sodium and
potassium counts showed positive results.
Sayantani: Alright then. Thank you so much taking time to
talk to me about this and for providing me your reports before.
Those will help me with mu school project.
Debdeep: That’s fine! No problem. Good luck for you project.
Sayantani: Thanks a lot again. Bye!

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C
A
S
E

S
T
U
D
Y

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BIODATA OF PATIENT

1) Name - DEBDEEP DAN

2) D.O.B - 16th June 2005

3) Age - 14yrs (as of 2019)

17yrs (as of 2022)

4) Blood Group – A+
5) Gender – Male
6) Disease – Right Lobe Parotitis
7) Category – Infectious Disease
8) Doctors Consulted – (a) Dr. Siddhartha Ghosh

(b) Dr. Puspendu Bikas Mandal

(c) Dr. Santosh Kumar Dey

9) Last Test – 2nd January ,2020

10) Last Test Report – Completely cured with low Serum
Sodium levels.

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I. Doctor Consulted – Dr.Sidhhartha Ghosh

II. Identification –Parotitis
III. Medication – i) Calpol 650
ii) Lorfast
iii) Ofal 2
iv) Plenty of ORS

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I) Doctor Consulted – Dr. Puspendu Bikas Mondal

II) Identification – Right Sided Parotitis
Left sided Sub-Mandibular Adenitis
III) Treatment – i) Spectraxime 500
ii) Calpol 650
iii) Plenty of Water

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I. Doctor Consulted – Dr. Santosh Kumar Dey

II. Identification – Right Sided Parotid Gland Swelling
III. Medication – i) Augmentin 650 Duo
ii) Veloz 20
iii) Domstal 20
IV. Advice –i) Adequate Fluid Intake & Extra Salt Meal
ii) Hospitalization ( In case of no +ve result)
V. Test – i) USG
ii) Blood Test (Na,K,Ca,ESR,Platelet Count)
iii) Dengue Test

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Fig.: USG of Right and Left Parotid & Submandibular Glands

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RESULT ANALYSIS

The person suffered from Rt. Lobe Parotitis which takes place
due to inflammation of the parotid gland. In this case the patient
got affected by the Mumps virus even after being vaccinated
fully for Mumps prevention.
The initial symptoms included inflammation, irritation, fever at
regular intervals, acute pain and difficulty in jaw movement.
The reasons diagnosed were very low sodium diet.
The result was a 21 day long suffering including excess water
loss and weakness resulting in chances of hospitalization.
The treatments consisted of
i) High Sodium Diet
ii) Adequate fluid Intake
iii) Full bed rest of 1week
iv) Medications to counter infection and pain
Post Recovery –
2 months from recovery the patient was again infected but this
time symptoms were simple and included throat irritation
which were easily treated by regular gargle with hot water and
bitadine.

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BIBLIOGRAPHY

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