A 70-year-old dehydrated man recovering from major abdominal surgery develops acute, tender, unilateral parotid swelling with pus expressed from the duct papilla. The most common causative organism is:

• A Streptococcus pyogenes
• B Escherichia coli
• C Haemophilus influenzae
• D Staphylococcus aureus ✓

Explanation

Acute suppurative (bacterial) parotitis classically affects debilitated, dehydrated, or postoperative patients in whom reduced salivary flow allows retrograde ascent of organisms up Stensen duct. Staphylococcus aureus is the most common isolate, followed by streptococci and anaerobes. Management is rehydration, sialogogues, and antistaphylococcal antibiotics, with drainage if an abscess forms. Streptococcus pyogenes is a less frequent cause, and gram-negative organisms are uncommon in community-acquired parotitis.

Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.