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Annual influenza outbreaks result in seasonal flu epidemics of acute viral respiratory disease related to influenza A or B infection. These outbreaks typically cause fever, headache, malaise, and myalgia with symptoms of upper respiratory infection including cough, rhinorrhea, and sore throat. During one month in 2018, Stafford et al. (2018) diagnosed and managed four patients with sialadenitis related to influenza A. Two cases involved the bilateral submandibular glands, one case involved bilateral parotid glands and one submandibular gland, and one case involved one parotid gland. These authors indicated that the Centers for Disease Control and Prevention reported hundreds of confirmed influenza cases with associated parotitis during the 2014–2015 influenza season, primarily related to influenza A (H3N2) infection. The cause of the association of influenza A and sialadenitis is not clear. Dehydration related to respiratory influenza infection might make patients prone to salivary stasis, or it is possible that the virus may directly involve salivary tissue with resultant sialadenitis.

Figure 3.19. A 6‐year‐old African female with AIDS showing involvement of the right parotid gland by diffuse infiltrative lymphocytosis syndrome (DILS).