Skip to content


  • Case report
  • Open Access
  • Open Peer Review

Idiopathic eosinophilic parotitis in an eight-year-old boy: a case report

  • 1Email author,
  • 1,
  • 2,
  • 3 and
  • 4
Journal of Medical Case Reports20115:385

  • Received: 25 February 2011
  • Accepted: 16 August 2011
  • Published:
Open Peer Review reports



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.

Case presentation

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.


  • Mumps
  • Food Allergen
  • Eosinophilic Esophagitis
  • Eosinophilic Pneumonia
  • Parotitis


A number of medical conditions are associated with increased production of eosinophils. A few of the most well known are eosinophilic pneumonia [1], eosinophilic bronchitis [2], and non-allergic rhinitis with eosinophilia syndrome nares and related disorders [3], but new entities such as eosinophilic esophagitis [4] 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 [5]. 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 [6]. 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.

Case presentation

Our patient was an eight-year-old Caucasian boy with no family history of atopy who had been in good health until the age of six years, when he started to have recurring episodes of acute parotitis with no fever, amounting to a total of five episodes, and no response to antibiotics, but remission was achieved with oral corticosteroid therapy. We performed allergy tests, including skin prick tests with a standard panel of allergen extracts (Stallergenes, Milan, Italy), patch tests for allergens and haptens, and a radioallergosorbent test for inhalant and food allergens, all of which produced negative results, and echography ruled out sialodochitis. His blood examination, which included tests for anti-nuclear antibodies and anti-DNA antibodies for the assessment of autoimmunity, revealed only a high level of amylase, but a tissue swab taken from the parotid duct allowed us to detect a high number of eosinophils (Figure 1).
Figure 1
Figure 1

Microscopic scan showing the material obtained from a swab of the parotid duct.


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.



Authors’ Affiliations

Pediatrics, University Department of Medical and Surgical Specialties and Public Health, Perugia, Italy
Scientific Department, Stallergenes, Milan, Italy
Department of Ophthalmology and Otorhinolaryngology, University of Bari, Bari, Italy
Allergy/Pulmonary Rehabilitation, ICP Hospital, Milan, Italy


  1. Cottin V, Cordier JF: Eosinophilic pneumonias. Allergy. 2005, 60: 841-857. 10.1111/j.1398-9995.2005.00812.x.View ArticlePubMedGoogle Scholar
  2. Ellis AK, Keith PK: Nonallergic rhinitis with eosinophilia syndrome and related disorders. Clin Allergy Immunol. 2007, 19: 87-100.PubMedGoogle Scholar
  3. 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
  4. 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
  5. 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
  6. 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


© Frati et al; licensee BioMed Central Ltd. 2011

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 (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.