SURGICAL DISEASES, TRAUMATOLOGY, ORTHOPEDICS, UROLOGY : MUMPS (PAROTITIS) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Etiology. Formed when injected into the parotid gland purulent (Streptococcus, Staphylococcus) or putrid infection. Penetrates infection often from the mouth; possible hematogenous her way.
The pathogenesis. A frequent complication of various infectious diseases (typhus and typhoid fever, septic diseases, scarlet fever, smallpox) and heavy (depleted) patients. Postmortem diverse picture: inflammatory edema without purulent foci, multiple small pustules, large ulcers front of the ear tragus, in the lower pole or in the medial part of the gland, often interconnected, cellulitis with soaking pus parotid region, with thatcame on the neck, in the temporal region, on the cheek, gangrene tissue of the gland with its preliminary soaking turbid serous exudation and infiltration on the face and neck.
Symptoms. Pain in the parotid region, difficulty in opening the mouth and chewing. Rapidly increasing swelling in the parotid region, higher temperatures sometimes in the range of 37.5 - 38º, sometimes up to 39 - 40º. On 5 - 6th day marked edema in the subcutaneous tissue and redness shiny swollen skin, when distributing process develops trism, very slow heartbeat, swelling and spasm of the glottis, pain, difficulty swallowing, swelling of the lateral wall of the pharynx, paresis of the facial nerve.
Course and complications. Negaunee form mumps ends in self-recovery: infiltrate resolved, the pain decreases, the temperature falls. Often formed ulcers, independent autopsy which hampered by tight fascia (happens often in the ear canal). Dead parts of the gland are allocated through the perforated holes or surgical incisions. Perhaps the spread of the inflammatory process on omologato region (omologata side cellulitis), along the large neck vessels on the neck, into the cavity of the skull, bleeding from large vessels, and the development of sepsis.
Recognition is facilitated by history. Difficulties can be when differencirovanie from mumps. Helps the blood test, not giving in mumps big changes (low leukocytosis, no shift).
Operation at more solid tumor in the first days of the disease. In the postoperative period, penicillin, sulfonamides, blood transfusion.