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A clinical diagnosis of left suppurative parotitis was established. He was subjected to urgent incision and drainage of the left parotid abscess and multiple fascial space abscesses in the operating room (Figure 3.21e) and three Penrose drains were placed (Figure 3.21f). Final culture and sensitivity identified methicillin‐resistant Staphylococcus aureus sensitive to vancomycin. The patient received one week of intravenous vancomycin postoperatively with monitoring of his peaks and troughs and his renal function. He recovered well and was discharged from the hospital following a one‐week admission. He is noted at six months following the incision and drainage procedure (Figure 3.21g). The left parotid gland swelling resolved and his gland recovered from the suppurative parotitis as noted by the production of saliva.

Figure 3.21. A 71‐year‐old man (a) demonstrated significant left facial swelling related to his acute left parotitis. Examination of the oral cavity identified thick pus at the left Stensen duct (b) and the ability to express significant pus at this site by massage of the left parotid gland. (c and d) CT imaging identified obvious abscess of the left parotid gland and involvement of numerous fascial spaces. (e) The patient underwent urgent incision and drainage that liberated substantial pus from the left parotid gland. Three Penrose drains were placed (f). Culture and sensitivity identified methicillin‐resistant Staphylococcus aureus, sensitive to vancomycin. (g) The patient improved in the hospital and resolved his parotitis as noted at six months postoperatively.