Right Parotid Abscess Secondary to Sialolithiasis in a Patient with Type 2 Diabetes Mellitus: A Case Report

One important obstructing cause of salivary gland inflammation is sialolithiasis. Most salivary calculi occur in the submandibular gland, but in cases of parotid duct calculi, facial swelling with pain may develop, and can lead to suppurative parotitis or abscess formation. We report a case of a 51-year-old type 2 diabetes mellitus patient who presented with a progressive right parotid swelling for 25 days with fever and difficulty in eating. Examination revealed a tender, warm and fluctuant swelling about 6 x 7cm and an obvious tender swelling was not found in the oral cavity, which revealed dental caries. Ultrasonography showed a bulky right parotid gland with altered echotexture, ductal dilatation, a 4-mm distal duct calculus, and a localized abscess collection. Leukocytosis, elevated C-reactive protein (CRP) and poor glycaemic control were found in the laboratory tests. Patient was treated with intravenous amoxicillin-clavulanate, analgesia, glycaemic optimization, ductal dilatation and pus removal, incision and drainage of the abscess and removal of the calculus. The authors point out that in diabetic patients who have pain, present the case of parotitis due to sialolith and outline the importance of early ultrasonic diagnosis and full drainage.

Keywords: Sialolithiasis, Parotitis, Parotid gland, Salivary duct calculus, Abscess, Diabetes mellitus.