喉頭浮腫を伴った非ムンプスウイルスによる耳下腺炎例

抄録

While in most cases, viral parotitis is caused by mumps virus, other viruses have also been known to cause the disease. Over 100 viruses have been documented as causing viral parotitis, including parainfluenza, coxsackie and Epstein-Barr virus. Dozens of cases of acute parotitis with laryngeal edema have been reported domestically.

We report a case of parotitis and submandibular inflammation associated with significant laryngeal edema that was caused by a non-mumps virus.

The patient was a 34-year-old female who presented with a 3-day history of bilateral swelling of the parotid and submandibular regions. The swelling had become steadily worse and she complained of difficulty in swallowing. Physical examination revealed bilateral swelling of the parotid and submandibular regions. Laryngeal endoscopic examination showed significant edema of the epiglottis, valleculae and arytenoid cartilages of both sides. The patient was begun on intravenous steroid treatment, and the laryngeal edema immediately improved. Mumps was ruled out as the cause by the negative serum test for mumps virus antibodies, as also other viruses such as parainfluenza, coxsackie and EB viruses, by the negative serological tests for the respective viruses. We suspected some other virus as the cause.

Some cases of parotitis with laryngeal edema have been reported previously in Japan. It is presumed that parotitis with laryngeal edema is caused by circulatory disturbance because of bilateral swelling of the submandibular glands. Some reported cases of parotitis with laryngeal edema required tracheostomy.

In order to avoid unexpected or critical airway obstruction, laryngeal endoscopic examination and careful observation are important and essential.