Previously healthy child. His only history is that he was operated on for left cryptorchidism; he is correctly vaccinated for his age. When he was five years old, he presented for the first time with bilateral parotid inflammation (with erythema, swelling and pain), accompanied by fever, which was managed on an outpatient basis with amoxicillin-clavulanic acid and oral anti-inflammatory drugs. He had a second episode, also managed on an outpatient basis.
The third episode required hospital admission due to poor clinical evolution and general malaise after starting treatment with oral amoxicillin-clavulanic acid. Physical examination revealed a bilateral laterocervical tumour (initially on the right) that obliterated the mandibular angle, with no signs of fluctuation or secretion or inflammatory signs of Stenon's duct. Blood tests showed a significant leukocytosis (24 100/mm3) with neutrophilia (78.7%), C-reactive protein (CRP) of 4.11 mg/dl and elevated α-amylase (up to 1451 U/l). During admission, an ultrasound scan showed enlarged parotid glands with increased density, heterogeneous and hypoechoic foci. The patient was treated with amoxicillin-clavulanic acid for two days intravenously, followed by eight days of oral treatment, analgesia and anti-inflammatory drugs, with good subsequent evolution.
The Paediatric Infectious Diseases Department followed up the patient, from where the study was completed. An immunity study was performed, which was normal, rheumatoid tests were negative, and a serological study was negative, except for the mumps vaccination serology, which was positive.
She has not presented any new episodes for more than a year.