Gas-Forming Parotid Abscess in a Diabetic Patient: An Unusual Complication of Salmonella enteritidis Bacteremia

Parotid abscess, not only a focal infection but also a sequela of systemic infection, necessitates the detailed search for the underlying pathogens. A 76-year-old diabetic male visited the emergency room of a hospital because of intermittently low-grade fever and a painful lump in the right parotid gland region for 7 days. Progressive painful swelling of the gland with the signs of severe sepsis developed 3 days later. Computed tomography of the neck revealed a cavitary lesion with an air-fluid level in the right parotid space. Superficial parotidectomy was performed. Salmonella enteritidis was isolated from both the pus and the blood culture. After a 2-week course of intravenous ampicillin and an additional 2-week course of oral moxifloxacin, he was free from recurrence at a 6-month follow-up. This case highlights that an initially nontoxic parotitis may be the presenting feature of extraintestinal salmonellosis. Early diagnosis and treatment are important to prevent lethal dissemination in high-risk groups.