Giant Parotid Abscess With Significant Skin Necrosis: A Case Report.
Dan Lu, Jiaxin Cui, Yuhang Xie et al.
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Case in brief
A 70-year-old man with poor glycemic control presented with 15 days of progressively worsening right parotid-region swelling, congestion, and pain. Clinical, imaging, and laboratory findings supported a diagnosis of a giant parotid abscess with extensive overlying skin necrosis caused by Klebsiella pneumoniae. The abscess responded poorly to prolonged intravenous broad-spectrum antibiotics. He then underwent daily Bacillus exchange, with blood glucose management and electrolyte monitoring. At three-month follow-up, the parotid abscess and skin rupture had completely resolved.
What made this case unusual
The abscess was accompanied by extensive skin necrosis, an uncommon complication noted by the authors, in a patient with poor glycemic control.
Diagnostic / clinical pearl
In a patient with poor glycemic control and progressive parotid-region inflammation, consider parotid abscess even when extensive skin necrosis is present; this case was diagnosed using clinical, imaging, and laboratory findings.