A 44-year-old male, with grade II obesity (BMI = 39.6), who presented with viral parotitis, progressive swelling of both parotid glands, accompanied by episodes of pulmonary recititis.
As complementary imaging tests were performed chest radiography, cranial CT and transesophageal ultrasound, which showed no abnormalities.
An EEG showed sinus rhythm, occasionally presenting bradycardias followed by sinus pauses, but without changes suggestive of coronary event.
A contrast-enhanced cervicothoracic CT was also requested, which showed an increase in size of both parotid glands, with softening of the adjacent fat and subcutaneous fluid streaks in the cervical tissue.
CT also showed numerous swollen lymph nodes at the cervical level, some of them compressing both carotid arteries.
1.
Cardiac enzymes, such as troponin I, remained at all times within the normal range, thus not suggesting a coronary event.
Intravenous treatment was initiated with clavulanic acid at a rate of one gram every 8 h and oral administration of ibuprofen 600 mg every 8 h, together with the placement of transient amoxicillin, showing a good evolution.
Initially, the patient presented phases of rhythm abnormalities mainly nocturnal, which were less and less frequent, while the glandular inflammation decreased.
After 48 h without observing temporary discharges, it was decided to remove it, with good tolerance and discharge 2 days later.
Fourteen months after the episode, the patient is asymptomatic and has not suffered any type of cardiovascular event.
Follows periodic reviews by the Maxillofacial Surgery and Cardiology Services, as well as by the Department of Endocrinology and Nutrition, for control and treatment of obesity presented.
