Abstract
Background: Parotid abscess is an uncommon condition, but it can cause potentially lethal systemic infections. The aim of this study was to analyze cases with parotid abscess during 15-year period and further determine the optimal diagnostic and therapeutic modalities at a tertiary medical center in Taiwan. Patients and Methods: Nineteen patients diagnosed with parotid abscess were retrospectively analyzed from November 2002 to October 2017. Patients' clinical symptoms, etiology, diagnostic methods, bacteriology, and antibiotic and surgical treatment were evaluated. Results: Among 19 patients diagnosed with parotid abscess, 12 were male and 7 were female. Their diagnostic ages ranged from 25 to 88 years (mean 55.5 years). The most common symptoms at initial presentation were painful swelling of the intra-auricular region and fever. Typical etiologies were odontogenic infections or poor oral hygiene. Thirteen out of 18 patients with drainage of abscess showed positive finding of bacterial cultures, and the most common pathogen was Klebsiella pneumoniae in six patients. One patient received intravenous antibiotics alone but eventually died of sepsis. In addition to antibiotic treatment, the other 18 patients underwent a combination of antibiotic treatment and drainage of abscess. Among them, 14 patients received surgical drainage and 4 patients received ultrasound-guided needle aspiration of abscess. After drainage, all had complete resolution of disease without recurrence or sequelae during at least 1 year of follow-up.Conclusions: This study highlights that K. pneumonia is an important pathogen of parotid abscess in consideration of the rapidly increasing cases of diabetes mellitus in Taiwan. In addition to early diagnosis, parotid abscess should be managed with broad-spectrum antibiotics, adequate hydration, and appropriate drainage to prevent unwanted morbidity and mortality.
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