Presentation
Bilateral painless swelling of the submandibular glands 12 hours after receiving intravenous contrast for a CT.
Patient Data
Symmetrical bilateral enlargement of the submandibular glands with prominent internal hypoechoic septae. Increased vascularity in the right gland (no left sided doppler imaging saved).
A follow up ultrasound performed 3 weeks later demonstrates normal submandibular glands with complete resolution of previous findings.
Case Discussion
Iodide mumps is a rare self-limiting adverse reaction to administering intravascular iodine-containing contrast medium. Treatment is conservative, with no recognized effective therapy. Of note, our patient had reported a previous "contrast allergy" of neck swelling without angioedema or anaphylaxis. She was prescribed prophylactic oral steroids and antihistamines, which failed to prevent her subsequent reaction. She was also on continuous peritoneal dialysis for chronic renal failure, a proposed predisposing factor to developing this condition due to impaired contrast clearance and accumulation in the salivary glands.
Co-author: Dr D Demeyer