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Clinical Challenge
June 2, 2022

Recurrent and Recalcitrant Salivary Gland Swelling in a Woman

Author Affiliations
  • 1Naval Medical Center San Diego, San Diego, California
  • 2Naval Aerospace Medical Institute, Pensacola, Florida
JAMA Otolaryngol Head Neck Surg. 2022;148(8):785-786. doi:10.1001/jamaoto.2022.1075

A 32-year-old Black woman presented with a 1-year history of facial swelling, predominantly in the right preauricular and left submandibular regions. Her symptoms began after relocation to California and occurred more frequently at her home. However, she could not discern any environmental or dietary triggers. She reported pruritus and swelling, which were usually moderate but occasionally severe, prompting several emergency department visits. During an emergency department visit, she was diagnosed with acute parotitis based on clinical and radiographic findings of diffuse gland edema, without salivary stones or masses. Her symptoms responded to oral prednisone bursts and diphenhydramine, but not to second-generation antihistamines or montelukast.

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