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March 2002
Parotid gland enlargement
 Parotid gland enlargement with or without xerostomia has been described in both adults and children with HIV infection. Nine of 158 HIV-infected children followed at Texas Children’s Hospital between 1990 and 1994 experienced parotid enlargement. Salivary gland biopsies demonstrate multifocal or diffuse lymphocytic infiltration consisting predominantly of CD8+ lymphocytes. Extraglandular involvement, particularly lymphocytic interstitial pneumonitis, is common. This condition has been termed the diffuse infiltrative lymphocytosis syndrome (DILS). The etiology of the syndrome is unclear, but HIV has been cultured from salivary gland tissue in some cases. Cytomegalovirus and human herpesvirus type 6 also have been implicated, as has a Sjogren's syndrome-like autoimmune process. HIV-associated parotid gland enlargement must be differentiated from mumps and suppurative parotitis, both of which generally are associated with fever and local pain and tenderness. HIV-associated parotid gland enlargement per se does not require treatment.
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