腮腺炎

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Parotitis
分类和外部资源
所属专业 Q788926[*]
ICD-10 B26
ICD-9-CM 072.9, 527.2

腮腺炎Parotitis)是指一個或兩個腮腺(人類臉頰兩旁的主要唾腺發炎的疾病。腮腺是唾腺中最經常發炎的一個部位。

病因[编辑]

感染性腮腺炎[编辑]

急性細菌性腮腺炎[编辑]

目前已知最常造成細菌性腮腺炎的是金黃色葡萄球菌Staphylococcus aureus),但也有可能是任何一種在身體上共生的細菌[1]

外結核性腮腺炎[编辑]

造成肺結核分枝桿菌也可能造成腮腺炎。感染者通常腮腺會腫大、無壓痛,不會太痛。診斷方法為放射性照影、培養,或組織切片。一旦發現是外結核性腮腺炎便給予抗肺結核處方,通常1-3個月即會消退[1]


急性病毒性腮腺炎[编辑]

The most common viral cause of parotitis is mumps. Routine vaccinations have dropped the incidence of mumps to a very low level. Mumps resolves on its own in about ten days.

HIV parotitis: Generalized lymphadenopathy has long been associated with HIV, but the localized enlargement of the parotid gland is less well known[來源請求].

自體免疫疾病[编辑]

These are also collectively known as chronic punctate parotitis or chronic autoimmune parotitis.

Sjögren's syndrome: Chronic inflammation of the salivary glands may also be an autoimmune disease known as Sjögren's syndrome. The disease most commonly appears in people aged 40–60 years, but it may affect small children. In Sjögren syndrome, the prevalence of parotitis in women versus men is approximately 9:1. The involved parotid gland is enlarged and tender at times. The cause is unknown. The syndrome is often characterized by excessive dryness in the eyes, mouth, nose, vagina, and skin.[1]

Mikulicz disease: Antiquated name for any enlargement of the parotid gland that was not tuberculosis, leukemia, or some other identifiable disease.

Lymphoepithelial lesion of Godwin: Most frequently associated with a circumscribed tumor with the histologic features of Sjögren syndrome. This designation has also fallen out of favour.

Blockage[编辑]

Blockage of the main parotid duct, or one of its branches, is often a primary cause of acute parotitis, with further inflammation secondary to bacterial superinfection. The blockage may be from a salivary stone, a mucous plug, or, more rarely, by a tumor, usually benign. Salivary stones (also called sialolithiasis, or salivary duct calculus) are mainly made of calcium, but do not indicate any kind of calcium disorder.[2] Stones may be diagnosed via X-ray (with a success rate of about 80%[2]), a computed tomography (CT) scan or Medical ultrasonography. Stones may be removed by manipulation in the doctor's office, or, in the worst cases, by surgery. Lithotripsy, also known as "shock wave" treatment, is best known for its use breaking up kidney stones. Lithotripsy can now be used on salivary stones as well. Ultrasound waves break up the stones, and the fragments flush out of the salivary duct.[2]

Diseases of uncertain etiology[编辑]

Chronic nonspecific parotitis: This term is generally used for patients in whom no definite etiology is found. Episodes may last for several days, paralleling the time course of a bacterial or viral illness. Others may experience episodes that last only a few hours from onset to resolution. Some episodes may last for several weeks. Quiescent periods between episodes last for hours, days, or even years.[1]

Recurrent parotitis of childhood: An uncommon syndrome in which recurring episodes clinically resembling mumps. Generally, episodes begin by age 5 years, and virtually all patients become asymptomatic by age 10–15 years. The duration of attacks averages 3–7 days but may last 2–3 weeks in some individuals. The spectrum varies from mild and infrequent attacks to episodes so frequent that they prevent regular school attendance. Local heat applied to the gland, massaging the gland from back to front, and taking penicillin usually cure individual episodes. Treatment of individual infections may prevent injury to the gland parenchyma. Severe disease may be treated by parotidectomy.[1]

Sialadenosis (sialosis): In this disorder, both parotid glands may be diffusely enlarged with only modest symptoms. Patients are aged 20–60 years at onset, and the sexes are equally involved. The glands are soft and non-tender. Approximately half of the patients have endocrine disorders such as diabetes, nutritional disorders such as pellagra or kwashiorkor, or have taken drugs such as guanethidine, thioridazine, or isoprenaline.

Sarcoidosis: The lungs, skin, and lymph nodes are most often affected, but the salivary glands are involved in approximately 10% of cases. Bilateral firm, smooth, and non-tender parotid enlargement is classic. Xerostomia occasionally occurs. The Heerfordt-Waldenstrom syndrome consists of sarcoidosis with parotid enlargement, fever, anterior uveitis, and facial nerve palsy.[1]

Pneumoparotitis: Air within the ducts of the parotid gland with or without inflammation. The duct orifice normally functions as a valve to prevent air from entering the gland from a pressurized oral cavity. Rarely, an incompetent valve allows insufflation of air into the duct system. Pneumoparotitis most commonly occurs in wind instrument players, glass blowers, and scuba divers.[1]

Several lymph nodes reside within the parotid gland as a superficial and deep group of nodes. These nodes may be involved with any process that affects lymph nodes, including bacterial, fungal, viral, and neoplastic processes. Rarely, drugs such as iodides, phenylbutazone, thiouracil, isoproterenol, heavy metals, sulfisoxazole, and phenothiazines cause parotid swelling.

註釋[编辑]

  1. ^ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 [1] Templer JW , MD, Professor of Otolaryngology, University of Missouri Medical Center at Columbia. Parotitis: Overview, Accessed 03/04/2009
  2. ^ 2.0 2.1 2.2 Salivary Gland Stones (Salivary Calculi) Accessed March 20, 2008.

參考文獻[编辑]

  • Brook I. Acute bacterial suppurative parotitis: microbiology and management. [Journal Article] Journal of Craniofacial Surgery. 14(1):37-40, 2003.
  • Mandel L. Surattanont F. Bilateral parotid swelling: a review. [Review] [160 refs] [Journal Article. Review] Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontics. 93(3):221-37, 2002.

外部連結[编辑]

Template:Inflammation Template:Oral pathology