Clinical case of recurrent parotitis in a child.Discussion of causes

Mavrutenkov, V.V. and Chykarenko, Z.O. and Zhukova, N.V. (2018) Clinical case of recurrent parotitis in a child.Discussion of causes. Здоров’я дитини, В. 13 (№ 3). pp. 311-316. ISSN 2224-0551 (print), 2307-1168 (online)

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Abstract

Currently, with introduction of vaccination against epidemic parotitis, differential diagnosis of salivarygland involvement in children should include other viruses, such as cytomegalovirus, Coxsackie virus, herpes virustype 6, human T-lymphotropic virus, human immunodeficiency virus, etc., as well as autoimmune and oncologicdiseases. Comprehensive differential diagnosis is required before establishing the diagnosis of exclusion, such as juvenilerecurrent parotitis. It will ensure more effective therapeutic approach and avoiding the prescription of unnecessarymedicines and manipulations. The article presents detailed clinical case of recurrent parotitis in a fully vaccinated(according to national vaccination schedule) 6-year-old boy, who experienced several episodes of painlessswelling of the left parotid area without fever or with low-grade fever accompanied by redness in the left eye duringobservation. Performed laboratory survey and instrumental examination are given. Methods and efficacy of therapeuticapproach are described. The article presents etiological classification of salivary gland involvement, whichincludes inflammatory diseases, autoimmune and hypertrophic lesions, obstructive and traumatic conditions, developmentaldefects, tumors. Epidemiologic and etiologic features of parotitis in pediatric population are considered.Differential diagnosis also includes, for example, Sjogren’s syndrome, sarcoidosis, cat-scratch disease, Parinaudconjunctivitis, with description of diagnostic criteria of the mentioned conditions. According to clinicians, juvenilerecurrent parotitis was diagnosed in the presented case. The article presents epidemiological features of this pathology,diagnostic criteria, discussion of possible etiology, recommendations for the management. Necessity and safetyof vaccination against epidemic parotitis were accentuated, as well as importance of avoiding the prescription of unnecessarymedicines. Vaccination against epidemic parotitis is a prerequisite for the prevention of viral lesions of thesalivary glands. It also helps to narrow the differential diagnosis of parotitis causes. If diagnosis of epidemic parotitisis excluded in a child, comprehensive clinical, laboratory and instrumental examination is recommended. It is veryimportant to provide follow-up after the first episode of parotitis in order to exclude recurrent course of the disease.In the presence of recurrent parotitis and exclusion of other causes of damage to the parotid salivary gland, it shouldbe suggested that the child has juvenile recurrent parotitis, which is a diagnosis of exclusion, and can be made afterat least 12 months of follow-up. The drug management of juvenile recurrent parotitis should exclude unreasonableprescription of medicines, such as antibiotics, antiviral drugs and especially immunomodulators. Only symptomatictherapy is indicated, providing relief of symptoms. Systematic follow-up of patients with this pathology is required.

Item Type: Article
Uncontrolled Keywords: parotitis infection; children; differential diagnosis; juvenile recurrent parotitis
Subjects: Infectious diseases
Divisions: Departments > Department of Infectious Diseases
Depositing User: Ирина Медведева
Date Deposited: 11 Jun 2019 12:54
Last Modified: 11 Jun 2019 12:54
URI: http://repo.dma.dp.ua/id/eprint/4101

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