Deep lobe parotid abscess with facial nerve palsy: a case report / Absceso del lóbulo profundo de la parótida con parálisis del nervio facial: un reporte de caso

Acute suppurative sialadenitis mostly occurs in the parotid gland, while parotid abscesses principally arise in the superficial lobe. However, facial nerve palsy, secondary to parotid abscess, is rare. Predisposing factors for the ductally ascending infection are dehydration, xerogenic drugs and salivary gland diseases associated with ductal obstruction or reduced saliva secretion. Obstruction of Stensen's duct and diminished production of saliva are regarded as the promoting factors. Painful swelling of the preauricular region and cheek is the most familiar symptom of acute suppurative parotitis. The most common pathogens associated with acute bacterial infection are Staphylococcus aureus and anaerobes. We report a rare case of deep lobe parotid abscess with facial nerve palsy. Aside from adequate fluid hydration, good oral hygiene and treatment with empiric parenteral antibiotics, surgical treatment with drainage can provide a remedy for this disease.

La sialoadenitis aguda supurativa aguda ocurre sobre todo en la glándula parótida, mientras que los abscesos parotídeos se producen principalmente en el lóbulo superficial. Sin embargo, la parálisis del nervio facial, secundaria al absceso parotídeo, es rara. Los factores predisponentes para la infección ascendente ductal son la deshidratación, los medicamentos xerogénicos, y las enfermedades de las glándulas salivales asociadas con obstrucción ductal o reducción de la secreción salival. La obstrucción del conducto de Stensen y la disminución de la producción de saliva, se consideran los factores promotores. Una inflamación dolorosa de la región preauricular y la mejilla es el síntoma más conocido de la parotiditis supurativa aguda. Los patógenos más comunes asociados con la infección bacteriana aguda son los anaerobios y el estafilococo dorado. Reportamos un caso raro de absceso del lóbulo parotídeo profundo con parálisis del nervio facial. Además de una hidratación fluida, una buena higiene oral y tratamiento con antibióticos parenterales empíricos, el tratamiento quirúrgico con drenaje puede proveer un remedio para esta enfermedad.

Amplification of dengue 2 virus ribonucleic acid sequence using the polymerase chain reaction.

The polymerase chain reaction (PCR) has been adapted to the amplification of dengue type 2 virus (DEN2) nucleic acid sequences. A pair of 20-mer oligonucleotides were designed and synthesized based on conserved sequence blocks of DEN2 strains isolated from different geographical areas. RNA samples were prepared from two DEN2 strains, prototype New Guinea C (NGC) and local isolate Hainan 98 (HN98). The reverse transcription step was performed for cDNA synthesis before the standard PCR procedures. The amplified products were fragments about 476 bp in length, corresponding to the upper one third of DEN2 envelope gene (E1 to E476 nt). Specificity of the amplification products was confirmed by "nested" PCR using the internal primers and by Southern and dot blot hybridization to cloned DEN2 cDNA probes following agarose gel electrophoresis. Further improvement and the potential application of the methods in study of dengue virus RNA are discussed.