Neonatal Parotitis: A Case Report and Review of the Literature

Background: Neonatal parotitis is a rare disease. Between 1970 and 2011 only 44 cases have been reported in the English literature. Methods: In this case report, we describe a case of neonatal parotitis caused by Group B streptococcus (GBS). Additionally, we performed a review of the recent literature. We found 18 new cases published between 2011 and 2020. These cases were analyzed together with the 44 cases published before 2011. Results: All patients presented with swelling over the parotid area, with varying degrees of local inflammation and general symptoms. Purulent discharge from the Stensen’s duct was present in 85% of the patients. The swelling was usually unilateral (84%). In total 70% of the patients were male. Prematurity was reported in 29% of the cases. The most common isolated pathogen was Staphylococcus aureus (68%). Only 5 cases were found describing GBS as the causative pathogen in neonatal parotitis. In most of the cases treatment with intravenous antibiotics was successful, 27% of the patients needed surgical drainage. The reported outcomes were good. Conclusions: When comparing GBS cases and non-GBS cases there seems to be a difference in presenting symptoms and pathophysiology, with GBS patients presenting without purulent discharge form the Stensen’s duct and with more severe generalized symptoms. Additionally, all GBS patients had a positive blood culture, compared to 27% of the non-GBS patients, which indicates that in GBS cases the major route of parotid infection is hematogenous, compared to a retrograde flow from the oral cavity to the parotid gland in non-GBS cases.