Fall 2020: Daunting Diagnosis
Question:
A 42-year-old unvaccinated male presents to the ED as a referral from the dental clinic. He was treated for a “right dental abscess” without resolution. The patient presents with right facial swelling and erythema. Labs and a facial CT are obtained. What is the patient’s diagnosis?
Answer:
The facial CT demonstrated subcutaneous fat stranding adjacent to the parotid gland with concern for acute parotitis. There was diffuse cervical lymphadenopathy and no drainable fluid collection. ENT was consulted and diagnosed the patient with viral vs. bacterial parotitis. Given the patient’s progressive condition, ENT recommended admission to the hospital and infectious disease consultation. ID agreed that the patient had acute parotitis. A respiratory viral panel and mumps serology were obtained. The patient’s labs were later confirmatory for mumps.
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This article is published in EMpulse Fall 2020. See the full version of the print magazine online here.
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