This article has Open Peer Review reports available.
Idiopathic eosinophilic parotitis in an eight-year-old boy: a case report
© Frati et al; licensee BioMed Central Ltd. 2011
Received: 25 February 2011
Accepted: 16 August 2011
Published: 16 August 2011
A number of medical conditions, some of them recently reported, are associated with an increased production of eosinophils. We report the first case of eosinophilic parotitis in the literature.
The patient was an eight-year-old Caucasian boy who presented with a two-year history of recurring acute parotitis with no fever. He had had a total of five episodes with no response to antibiotics, but remission had been achieved with oral corticosteroid therapy. We performed allergy tests for inhalant and food allergens and for haptens, but the results were all negative. The results of echography ruled out sialodochitis. Instead, a swab from the parotid duct led to the detection of a high number of eosinophils.
This report is first in the literature to describe a case of eosinophilic parotitis, and we suggest that a cytological assessment, which is quite simple yet rarely used by physicians, be performed when patients with parotitis of uncertain origin are under evaluation.
A number of medical conditions are associated with increased production of eosinophils. A few of the most well known are eosinophilic pneumonia , eosinophilic bronchitis , and non-allergic rhinitis with eosinophilia syndrome nares and related disorders , but new entities such as eosinophilic esophagitis  and others are being added to this list. Very recently, a case of eosinophilic sialodochitis, that is, an inflammation of the parotid salivary duct was reported . In this report, we describe the first case of eosinophilic parotitis in the literature. Parotitis is an inflammation of the parotid salivary gland that can be acute or chronic with acute exacerbations. Concerning the etiology, viral parotitis is more common than bacterial parotitis, and mumps is the most common viral cause of parotitis . The diagnosis is made on the basis of the presence of firm, erythematous swelling in the pre- and post-auricular areas, intense local pain and tenderness, and high fever and chills. Later, massive swelling of the neck and respiratory obstruction may occur. Microbiological data may be obtained by collecting specimens by aspiration from the parotid duct orifice or, when this is not feasible, by obtaining a tissue swab from the papilla of the parotid gland, which is located opposite the second upper molar teeth. In addition, ultrasound imaging or sialography can be used to detect altered morphology, especially in patients with chronic diseases.
This report describes the first case of eosinophilic parotitis in the published literature, and we suggest that a cytological assessment, which is quite simple though rarely used by physicians, be performed when evaluating patients with parotitis of uncertain origin. Management is based on oral corticosteroid therapy.
Written informed consent was obtained from patient's parents for the publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
- Cottin V, Cordier JF: Eosinophilic pneumonias. Allergy. 2005, 60: 841-857. 10.1111/j.1398-9995.2005.00812.x.View ArticlePubMedGoogle Scholar
- Ellis AK, Keith PK: Nonallergic rhinitis with eosinophilia syndrome and related disorders. Clin Allergy Immunol. 2007, 19: 87-100.PubMedGoogle Scholar
- Brightling CE, Ward R, Goh KL, Wardlaw C, Pavord I: Eosinophilic bronchitis is an important cause of chronic cough. Am J Respir Crit Care Med. 1999, 160: 406-410.View ArticlePubMedGoogle Scholar
- Atkins D, Kramer R, Capocelli K, Lovell M, Furuta GT: Eosinophilic esophagitis: the newest esophageal inflammatory disease. Nat Rev Gastroenterol Hepatol. 2009, 6: 267-278. 10.1038/nrgastro.2009.45.View ArticlePubMedGoogle Scholar
- Pollak N, Templer JW, Esebua M, Diaz-Arias AA, Zitsch RP: Episodic painful parotid swelling caused by sialodochitis with eosinophilic inflammation: a new entity. Otolaryngol Head Neck Surg. 2009, 140: 132-133. 10.1016/j.otohns.2008.10.004.View ArticlePubMedGoogle Scholar
- Mason WH: Mumps. Nelson's Textbook of Pediatrics. Edited by: Kliegman RM, Behrman RE, Jenson HB, Stanton BF. 2007, Philadelphia: Saunders Elsevier, 1341-1344. 18Google Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.