Letter to the Editor
Parotid abscess by Candida glabrata
Absceso parotídeo por Candida glabrata
Daniel Pampín Ozán, Paolo Cariati
, Susana Arroyo Rodriguez
Corresponding author
Oral and Maxillofacial surgeon. Hospital General Universitario de Albacete, Oral and Maxillofacial Surgery Department, Albacete, Spain
Read
13
Timeswas read the article
7
Total PDF
6
Total HTML
Share statistics
array:24 [ "pii" => "S0025775320301202" "issn" => "00257753" "doi" => "10.1016/j.medcli.2020.01.017" "estado" => "S300" "fechaPublicacion" => "2021-05-21" "aid" => "5104" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2020" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2021;156:528" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S2387020621002072" "issn" => "23870206" "doi" => "10.1016/j.medcle.2020.01.039" "estado" => "S300" "fechaPublicacion" => "2021-05-21" "aid" => "5104" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2021;156:528" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Parotid abscess by Candida glabrata" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "528" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Absceso parotídeo por Candida glabrata" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Daniel Pampín Ozán, Paolo Cariati, Susana Arroyo Rodriguez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Daniel" "apellidos" => "Pampín Ozán" ] 1 => array:2 [ "nombre" => "Paolo" "apellidos" => "Cariati" ] 2 => array:2 [ "nombre" => "Susana" "apellidos" => "Arroyo Rodriguez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0025775320301202" "doi" => "10.1016/j.medcli.2020.01.017" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320301202?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621002072?idApp=UINPBA00004N" "url" => "/23870206/0000015600000010/v1_202105151030/S2387020621002072/v1_202105151030/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S002577532030213X" "issn" => "00257753" "doi" => "10.1016/j.medcli.2020.02.012" "estado" => "S300" "fechaPublicacion" => "2021-05-21" "aid" => "5159" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2021;156:529-30" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>" "titulo" => "Síndrome de Birt-Hogg-Dubé: descripción de un caso" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "529" "paginaFinal" => "530" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Birt-Hogg-Dubé syndrome: A case report" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1096 "Ancho" => 1500 "Tamanyo" => 206932 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">a) Pápula localizada en región malar derecha; b) Neoplasia renal cortical sólida de 31<span class="elsevierStyleHsp" style=""></span>mm localizada en polo superior del riñón derecho; c) Quistes pulmonares en lóbulo medio y língula.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan Margallo Iribarnegaray, Fernando Revuelta Salgado, María Teresa Martínez Martínez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Juan" "apellidos" => "Margallo Iribarnegaray" ] 1 => array:2 [ "nombre" => "Fernando" "apellidos" => "Revuelta Salgado" ] 2 => array:2 [ "nombre" => "María Teresa" "apellidos" => "Martínez Martínez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020621001996" "doi" => "10.1016/j.medcle.2020.02.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621001996?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577532030213X?idApp=UINPBA00004N" "url" => "/00257753/0000015600000010/v1_202105140726/S002577532030213X/v1_202105140726/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0025775320302128" "issn" => "00257753" "doi" => "10.1016/j.medcli.2020.01.039" "estado" => "S300" "fechaPublicacion" => "2021-05-21" "aid" => "5158" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2021;156:527" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>" "titulo" => "Pancitopenia tras administración de metotrexato intralesional en un paciente en programa de hemodiálisis" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "527" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pancytopenia after administration of intralesional methotrexate in a patient in hemodialysis program" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Elena María Gámez Jiménez, Julia Muñoz Ballester, Jon Badiola" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Elena María" "apellidos" => "Gámez Jiménez" ] 1 => array:2 [ "nombre" => "Julia" "apellidos" => "Muñoz Ballester" ] 2 => array:2 [ "nombre" => "Jon" "apellidos" => "Badiola" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020621001984" "doi" => "10.1016/j.medcle.2021.04.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621001984?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320302128?idApp=UINPBA00004N" "url" => "/00257753/0000015600000010/v1_202105140726/S0025775320302128/v1_202105140726/es/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Parotid abscess by Candida glabrata" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "528" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Daniel Pampín Ozán, Paolo Cariati, Susana Arroyo Rodriguez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Daniel" "apellidos" => "Pampín Ozán" ] 1 => array:4 [ "nombre" => "Paolo" "apellidos" => "Cariati" "email" => array:1 [ 0 => "paolocariati1@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "Susana" "apellidos" => "Arroyo Rodriguez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Oral and Maxillofacial surgeon. Hospital General Universitario de Albacete, Oral and Maxillofacial Surgery Department, Albacete, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Absceso parotídeo por Candida glabrata" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Salivary glands could be affected by acute and chronic infections. In this sense, parotid represents the salivary gland most commonly affected by infectious diseases. These infections could be acute or chronic and are usually caused by viruses or bacteria. Acute suppurative parotitis occurs mainly in elderly people affected by systemic diseases such as diabetes, immunosuppression and previous surgeries. Other predisposing factors include malnutrition, dehydration, oral cavity malignancies, ductal ectasia and medications that suppress salivary flow (antihistamines, diuretics and anticholinergic agents).<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> With respect to the etiology, Staphylococcus aureus is the pathogen most frequently associated with acute suppurative parotitis. Other pathogens reported are: streptococcus, gram negative bacilli and anaerobes. Fungal infections rarely affect the parotid gland. In these cases, the most common etiological agents are: Cryptococcus neoformans, Histoplasma capsulatum and Candida albicans. Specifically, parotid gland infections caused by Candida subspecies are extremely uncommon and only 6 cases have been described in the common literature.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,3</span></a> Thus, due to the rarity of this disease there is no consensus on the management and treatment of these cases. We report the case of a 50-year-old man with no medical history of interest. The patient was referred to our department due to the appearance of a hard and elastic nodule (1.5<span class="elsevierStyleHsp" style=""></span>cm in diameter) in the tail of right parotid of 3 months of evolution. The lesion was painful on palpation, mobile and not adhered to deep planes. Importantly, patient didn’t show signs of peripheral facial paralysis. Due to the findings observed in the clinical examination, an ultrasound of the parotid gland and a head and neck Ct scan were performed to guide the diagnosis. The ultrasound showed a well-defined nodular lump with posterior acoustic reinforcement. The CT scan evidenced a hypodense nodular lesion of 1.4<span class="elsevierStyleHsp" style=""></span>cm suggestive of parotid abscess. Moreover, an FNA (Fine-needle-aspiration) puncture was also performed. This test showed small intracytoplasmic inclusions and lymphohistiocytic cells, which were identified as spores by PAS staining. The microbiological study demonstrated the existence of yeast cells. Finally, Candida glabrata was isolated in the culture. After analyzing the antibiogram, the pathogen was considered resistant to fluconazole and susceptible to voriconazole. Hence, patient was referred to the department of Infectious Diseases of our hospital and oral treatment with voriconazole (200<span class="elsevierStyleHsp" style=""></span>mg twice per day for 6 weeks) was prescribed. The patient was again evaluated 2 months later. However, no improvements were observed after a careful clinical examination. A new Ct scan and a new culture showed the same result evidenced before starting antifungal treatment. Consequently, a new cycle of treatment with voriconazole (200<span class="elsevierStyleHsp" style=""></span>mg twice per day) was prescribed during three months. Unfortunately, the patient also did not respond to this new treatment cycle. Thus, patient underwent surgical treatment with superficial parotidectomy. Postoperative pathological examination confirmed the fungal infection by Candida glabrata. Interestingly, no signs of recurrence were evidenced 12 months after surgery. Despite its rarity, fungal infection should be considered in the differential diagnosis of localized abscess of salivary gland even in immunocompetent patients. The differential diagnosis includes a large number of neoplastic and non-neoplastic diseases. The growth of fungal subspecies such Cryptococcus neoformans, Histoplasma capsulatum or Candida in microbiological cultures is mandatory to guarantee a proper diagnosis. Because a large number of microorganisms are usually observed, fungal sialadenitis is usually easily distinguished from other pathologies. A potential problem might occur when the lesion presents central necrosis and the organisms are not abundant. Primary and metastatic malignant tumors that could be confused with fungal infections include mucoepidermoid carcinoma, acinar cell carcinoma and squamous cell carcinoma metastasis. The incidence of fungal infection as opportunistic disease has risen parallelly to the increase of immunosuppressive condition secondary to chronic illnesses, malignancies, transplants, immunosuppressive treatments, and HIV infection. The treatment depends on the specific subspecies.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Medical treatments based on antifungal agents such as fluconazole, voriconazole and ravuconazole might be useful and should always be considered as the first-choice treatment.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> However, the high resistance rate observed to these substances in our case forced to choose the surgical treatment as the definitive option. A strict follow-up is recommended to facilitate the early diagnosis of eventual recurrences. Even in case of complete healing and long-term free disease, the possibility of relapses has to be considered.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical standards</span><p id="par0010" class="elsevierStylePara elsevierViewall">Authors declare we that they have taken into account the ethical responsibilities.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors’ contributions</span><p id="par0015" class="elsevierStylePara elsevierViewall">All authors participated in the creation of manuscript.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Financial assistance</span><p id="par0020" class="elsevierStylePara elsevierViewall">Authors not received financial assistance.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflict of interests</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interests.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Ethical standards" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Authors’ contributions" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Financial assistance" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interests" ] 4 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathology of salivary gland disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.L. Peel" 1 => "R.R. Seethala" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Saliv Gland Disord" "fecha" => "2007" "volumen" => "3" "paginaInicial" => "36" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Candida parotitis with abscess formation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Even-Tov" 1 => "A. Niv" 2 => "M. Kraus" 3 => "M. Nash" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/00016480500388992" "Revista" => array:6 [ "tituloSerie" => "Acta Otolaryngol" "fecha" => "2006" "volumen" => "126" "paginaInicial" => "334" "paginaFinal" => "336" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16618667" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Candidal abscess of the parotid gland due to Candida glabrata: report of a case and literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Enache-Angouvalnt" 1 => "F. Torti" 2 => "M. Tassart" 3 => "J.L. Poirot" 4 => "A. Jafari" 5 => "P. Roux" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Mycol" "fecha" => "2010" "volumen" => "48" "paginaInicial" => "402" "paginaFinal" => "405" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fine-needle aspiration biopsy of salivary gland mycoses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.S. Raab" 1 => "P.A. Thomas" 2 => "M.B. Cohen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Diagn Cytopathol" "fecha" => "1994" "volumen" => "11" "paginaInicial" => "286" "paginaFinal" => "290" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Stensen's duct obstruction by foreign body and subsequent candidal infection of the parotid gland" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P.K. Stefanopoulos" 1 => "D.T. Karakassis" 2 => "A. Triantafyllidou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1258/002221503768200066" "Revista" => array:6 [ "tituloSerie" => "J Laryngol Otol" "fecha" => "2003" "volumen" => "117" "paginaInicial" => "662" "paginaFinal" => "665" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12956927" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00257753/0000015600000010/v1_202105140726/S0025775320301202/v1_202105140726/en/main.assets" "Apartado" => array:4 [ "identificador" => "66430" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Cartas al Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00257753/0000015600000010/v1_202105140726/S0025775320301202/v1_202105140726/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320301202?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 2 | 1 | 3 |
| 2022 December | 1 | 0 | 1 |
| 2021 November | 1 | 0 | 1 |
| 2021 June | 1 | 2 | 3 |
| 2021 May | 1 | 4 | 5 |
