Syphilis induced parotitis

Introduction:

A 40 years old tunisian patient presented with persistent parotid swelling and intermittent parotitis recurring for one year. A diabetes type 2 was the only next diagnosis. In addition, the patient complained of persistent fatigue. Several frustran therapy trials with systemic antibiotics have been performed.

Methods:

Ultrasound sonography and an MRI of the head and neck region as well as a sialogram of the parotid glands were performed. Blood samples, rheumatoid factors, and lues-serology because of uncertain promiscuity were taken for analysis.

Results:

MRI-scan and ultrasound showed a parotid hyperplasia on both sides without any indication of a tumor or a structural alteration. There was no indication of a sialolothiasis in the sialogram. Routine Laboratory, differential blood count, and rheumatoid factors revealed no pathological findings. Serological blood tests were positive for latent syphilis (Treponema pallidum antibodies IgG positive, IgM negative). Thus, a treatment with Benzathine benzylpenicillin was started. Under treatment, the swelling regressed. No further infections of the parotid gland occurred. The fatigue of the patient also improved.

Discussion:

With appropriate anamnesis in a case of recurrent parotitis and persistent bilateral parotid swelling syphilis should be considered as a possible differential diagnosis.

Publication History

Publication Date:
18 April 2018 (online)