The lack of saliva might be associated with sticky saliva and taste impairment. The adenitis and the parotid-related enlargement might block the main gland duct (Stenon’s duct), leading to saliva retention and parotid tissue inflammation. The features we describe support the diagnosis of adenitis, which might impair the gland functioning. In our patients, the MRI results did not indicate cysts. Moreover, cysts have T1 (hypo) and T2 (hyper) signals that are similar than those of the cerebrospinal fluid ( 5). In a patient with HIV infection, the parotid lesions appear as multiple and bilateral parotid lymphoepithelial cysts, which are bigger than lymph nodes ( 5). Mumps-related parotitis usually occurs in children and might be bilateral ( 4). Our MRI findings mainly report diffuse enlargement of the gland without evidence of multiple intraglandular lymph nodes however, the literature remains limited because the diagnosis is clinical and MRI is not often required. Infection with rubella, herpes, influenza, and human immunodeficiency viruses can result in salivary tropism ( 3, 4), leading to diffuse parotitis. Our findings support the hypothesis that the parotitis-like symptoms might be attributable to intraparotid lymph node enlargement, which is different from a primary parotitis. The occurrence of acute parotitis related to COVID-19 has been suggested in a recent case report ( 2), corroborating the clinical observations of otolaryngologists. The 3 patients had persistent loss of smell after the resolution of their general and parotitis-like symptoms. The parotitis resolved over the next few days after diagnosis. The 3 patients received 10–14 days of paracetamol (1 g 3–4×/d) for their COVID-19. We also observed no intraglandular linear bands or cysts on the MRI ( Appendix). We observed no juxtaglandular fat infiltration or thickening of the fascia. ![]() We preserved the lymph node architecture by using a preserved fatty hilum. In all three cases, we observed multiple unilateral or bilateral intraglandular lymph nodes in the deep and surface layers, in a relatively normal-sized gland. Patients underwent magnetic resonance imaging (MRI), which indicated intraparotid lymphadenitis. The otolaryngologist did not see any pus draining from the parotid duct. A clinical diagnosis of parotitis was made in all 3 cases. The parotitis-like symptoms occurred at the onset of the disease in 2 patients and over the clinical course of the disease in the remaining patient. ![]() The patients had no notable medical histories, and they were all vaccinated against mumps. Diagnosis of COVID-19 was confirmed by reverse-transcription PCR tests on nasopharyngeal swab specimens. The patients also reported general and otolaryngologic symptoms, including anorexia, arthralgia, myalgia, headache, fatigue, nasal obstruction, rhinorrhea, postnasal drip, sore throat, face pain, and loss of smell and taste ( Table). Three women sought care at the Department of Otolaryngology–Head and Neck Surgery of Foch Hospital for unilateral ear pain and retromandibular edema. We report the clinical features of 3 outpatients who sought care at Foch Hospital (Paris, France) for parotitis-like symptoms in the context of COVID-19. Many otolaryngologists have observed an increase in the number of patients with acute parotitis (inflammation of the parotid salivary glands), which could be related to COVID-19 ( 2). Patients might have nose and throat symptoms, such as loss of smell and taste ( 1). The worldwide spread of coronavirus disease (COVID-19) is associated with the emergence of many clinical pictures of the disease.
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