Pneumoparotitis

Abstract

The objective is to review a case of pneumoparotitis and to discuss how knowledge of this unique presentation is important when making differential diagnoses in emergency medicine. A patient with recurrent subcutaneous emphysema of the head and neck is reviewed. Stenson's duct demonstrated purulent discharge. Physical examination revealed palpable crepitance of the head and neck. Fiberoptic laryngoscopy and barium esophagram were normal. Computed tomography demonstrated left pneumoparotitis and subcutaneous emphysema from the scalp to the clavicles. This is an unusual presentation of pneumoparotitis and malingering. Emergency physicians should be aware of pneumoparotitis and its presentation when creating a differential diagnosis for pneumomediastinum, which includes more life-threatening diagnoses such as airway or esophageal injuries.

Keywords: Facial swelling; Malingering; Mediastinal emphysema; Pneumoparotitis.

Fig. 1.

This figure is a computed tomography of the head and neck with intravenous contrast, axial view, showing (A) subcutaneous emphysema of scalp, (B) parotid glands, (C) mediastinal air; subsequent presentation showing (D) parotid glands.

Fig. 2.

This figure is a computed tomography of the head and neck with intravenous contrast, coronal view, showing (A) air within bilateral parotid glands and subcutaneous emphysema of the neck, (B) subcutaneous emphysema of the face.