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Since I Had Covid 3 Months Ago I Have Had
Question: Since I had covid 3 months ago I have had a slight swelling of my right parotid gland. This swelling is very minor and goes back down again in approx 10 secs. It isn't that noticeable but I feel it go hard sightly. Ot happens almost every single meal especially yje first meal of the day. The last meal of the day sometimes has no symptoms especially if it is a bland meal.
I have seen ENT who sent me for an ultrasound which was clear and all looked normal.
I asked of ot could ne damage from covid as I've seen so many studies online stating parotid problems after covid.
Or inflammation to the duct but no response back.
If it was an infection surely my body would have gotten rid of it as its been almost 3 months.
No fever no pain
Sometimes I think my tongue looks a bit whitish.
I was prescribed a 3 day course of antibiotics from my dentist 2 months ago for slight gum irration and if it was an infection I would have thought this antibiotic course would have cleared it up also
I have seen ENT who sent me for an ultrasound which was clear and all looked normal.
I asked of ot could ne damage from covid as I've seen so many studies online stating parotid problems after covid.
Or inflammation to the duct but no response back.
If it was an infection surely my body would have gotten rid of it as its been almost 3 months.
No fever no pain
Sometimes I think my tongue looks a bit whitish.
I was prescribed a 3 day course of antibiotics from my dentist 2 months ago for slight gum irration and if it was an infection I would have thought this antibiotic course would have cleared it up also
Sorry I meant to say that this ever so slight swelling only happens at meal times. It is absolutely fine the rest of the time
Brief Answer:
Mild Chronic Parotitis
Detailed Answer:
Hi,
Thank you for your query.
1. This is mild chronic parotitis. Bland food is less likely to cause intermittent swelling.
2. If the Ultrasound is negative, MRI Sialography will help identify any slight inflammation or radiolucent sand-like sludge which is common in the parotid salivary gland (unlike the sub-mandibular salivary glands). MRI Sialography is now the gold standard imaging for diagnosing salivary disease.
3. Conservative treatment will include warm fomentation, gentle massage, and foods that encourage salivary formation (sialogogues). Clindamycin is the antibiotic of choice here as it achieves the maximum concentration in saliva. Sometimes it is Long Covid that must be ruled out and sometimes it is an autoimmune process, either pre-existing or triggered off by the recent Covid infection.
4. Stensen's (Parotid) Duct irrigation is discouraged as it can drive infection deeper into the gland. Sialendoscopy is an option if all other conservative measures fail and there are signs on the MRI SIalography.
5. Are there any close-up images of the parotid gland opening in the inside of the cheeks, to compare the parotid papillae on both sides? You can upload the results here and take this discussion forwards.
I hope that I have answered your query.
If you have any further questions, I will be available to answer them.
Regards.
Mild Chronic Parotitis
Detailed Answer:
Hi,
Thank you for your query.
1. This is mild chronic parotitis. Bland food is less likely to cause intermittent swelling.
2. If the Ultrasound is negative, MRI Sialography will help identify any slight inflammation or radiolucent sand-like sludge which is common in the parotid salivary gland (unlike the sub-mandibular salivary glands). MRI Sialography is now the gold standard imaging for diagnosing salivary disease.
3. Conservative treatment will include warm fomentation, gentle massage, and foods that encourage salivary formation (sialogogues). Clindamycin is the antibiotic of choice here as it achieves the maximum concentration in saliva. Sometimes it is Long Covid that must be ruled out and sometimes it is an autoimmune process, either pre-existing or triggered off by the recent Covid infection.
4. Stensen's (Parotid) Duct irrigation is discouraged as it can drive infection deeper into the gland. Sialendoscopy is an option if all other conservative measures fail and there are signs on the MRI SIalography.
5. Are there any close-up images of the parotid gland opening in the inside of the cheeks, to compare the parotid papillae on both sides? You can upload the results here and take this discussion forwards.
I hope that I have answered your query.
If you have any further questions, I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you very much..
I did have another look inside my moth this morning and I can see a very tiny dot which looks like the opening to stensons duct. It looks slightly darker pin sized brownish colour possibly to it with a small amount of inflammation.
Would you recommend the mri scan first before antibiotics?
Are mri scans non invasive? Also I have 2 teeth that have dental implants in my mouth I'm not sure I can have mri?
Does this particular antibiotic target a bacterial infection? Or inflammation from covid?
Can I do anything else other than taking antibiotics to resolve this?
I'm taking lots of supplements including oregano oil but so far nothing has worked. Maybe they have kept infection at bay not sure
I did have another look inside my moth this morning and I can see a very tiny dot which looks like the opening to stensons duct. It looks slightly darker pin sized brownish colour possibly to it with a small amount of inflammation.
Would you recommend the mri scan first before antibiotics?
Are mri scans non invasive? Also I have 2 teeth that have dental implants in my mouth I'm not sure I can have mri?
Does this particular antibiotic target a bacterial infection? Or inflammation from covid?
Can I do anything else other than taking antibiotics to resolve this?
I'm taking lots of supplements including oregano oil but so far nothing has worked. Maybe they have kept infection at bay not sure
It's nothing long standing no immune conditions never any symptoms like this before.
It started 2 weeks after 1st day of covid when I started having bigger meals again. Furor time it happened was the worst.
How would long covid be ruled out?
Will antibiotics be helpful if this is from covid or if it is from covid is it a case of waiting until it resolves itself?
It started 2 weeks after 1st day of covid when I started having bigger meals again. Furor time it happened was the worst.
How would long covid be ruled out?
Will antibiotics be helpful if this is from covid or if it is from covid is it a case of waiting until it resolves itself?
I have attached a photo taken jyst now if my tongue it until always this white bit midt days there us z coating on it.
I dont think can capture the pin sized dot at my stensons duct opening as I think it's too small but I can try
I dont think can capture the pin sized dot at my stensons duct opening as I think it's too small but I can try
Forgetting mention I had a skin tash all over my body when I was on a course of erythromycin in my twenties. Not sure is this in the sane family of antibiotic you have suggested
Brief Answer:
Mild glossitis.
Detailed Answer:
Hi,
Thank you for following up.
1. The tongue coating and slightly scalloped edges of the tongue on both sides are due to mild glossitis also known as a crenated tongue. Common causes include acid reflux, dehydration, anxiety, bruxism and nutritional deficiencies leading to mild inflammation.
2. The inside of the mouth is not visible but by your description a course of clindamycin will help.Regarding antibiotic sensitivity, it is better to take this under the observation of a local doctor/ physician who can also prescribe supportive medicines to reduce inflammation.
3. In long covid, get repeat PCR swabs and antibody levels done. Usually the virus is eliminated in a couple of weeks (though not in all cases) and secondary inflammation, immune reactions and bacterial infections take over. Other tests include Hemogram, CRP, ESR, Thyroid Function Tests.
4. The MRI Sialography is non-invasive. No contrast is required as saliva itself is the contrast enhancing agent. The MRI center will decide regarding the dental implants before proceeding with a scan. The MRI can be done after the above-mentioned measures.
I hope that I have answered your query.
If you have any further questions, I will be available to answer them.
Regards.
Mild glossitis.
Detailed Answer:
Hi,
Thank you for following up.
1. The tongue coating and slightly scalloped edges of the tongue on both sides are due to mild glossitis also known as a crenated tongue. Common causes include acid reflux, dehydration, anxiety, bruxism and nutritional deficiencies leading to mild inflammation.
2. The inside of the mouth is not visible but by your description a course of clindamycin will help.Regarding antibiotic sensitivity, it is better to take this under the observation of a local doctor/ physician who can also prescribe supportive medicines to reduce inflammation.
3. In long covid, get repeat PCR swabs and antibody levels done. Usually the virus is eliminated in a couple of weeks (though not in all cases) and secondary inflammation, immune reactions and bacterial infections take over. Other tests include Hemogram, CRP, ESR, Thyroid Function Tests.
4. The MRI Sialography is non-invasive. No contrast is required as saliva itself is the contrast enhancing agent. The MRI center will decide regarding the dental implants before proceeding with a scan. The MRI can be done after the above-mentioned measures.
I hope that I have answered your query.
If you have any further questions, I will be available to answer them.
Regards.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Saisudha Kotla
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