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DrRussMD
DrRussMD, Board Certified Physician
Category: Medical
Satisfied Customers: 65289
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, health, prevention, complementary medicine, etc.
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Over the course of the afternoon I have developed a painful

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Over the course of the afternoon I have developed a painful swelling on the left side of my face. There is a golf-ball sized area of swelling - not hard and nodular but more "squishy" - extending from just below the temple and then wrapping under the jaw bone. There is low-grade pain without touching the area and it increases when the swelling is palpated. I am working right now and scheduled to work until 1AM. I then have an EXTREMELY important engagement, involving clients who have flown in from around the world, on Tuesday, that I CANNOT MISS. My question is whether I should try to find a 24hr urgent care center tonight when I get off work or wait until morning.
Hello
I am Dr. Thomas, double board certified physician with over 20 years of clinical experience. I will help you with your question and any follow up questions you have.
Go to urgent care or the ER.
If this is an allergic reaction, you will need prescription medicines.
If it is a parotid gland infection, antibiotics.
There is no way to say what will happen without examination and treatment based on exam.
Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 3 years ago.

I can pretty well guarantee it's not an allergic reaction. No history of allergies to anything, no other symptoms, inflammation is only on the one side, onset has taken hours-not-minutes. What is a "parotid gland" infection?

The gland is in the back of the face where you describe this swelling.
It can be a stone that has blocked the gland.
This can ultimately cause painful infection.
Only an exam is going to sort this out.
The description sounds like a swollen parotid gland.
Use reply to let me know if you have further questions.
Please do not forget a positive rating.
DrRussMD and 7 other Medical Specialists are ready to help you
Customer: replied 3 years ago.

Let us assume a swollen parotid gland. Sufficiently urgent to find a 24hr facility (there may not be a 24hr urgent care facility anywhere around so this likely means an ER visit)? I dislike abusing ERs as they are dealing with life-and-death issues, so I will do it if this is that sort of emergency but would avoid it otherwise.

it is sufficient cause to do either.
You have a sudden onset of abnormal swelling.
It should be looked at regardless.
Use reply to let me know if you have further questions.
Please do not forget a positive rating.
Customer: replied 3 years ago.

I don't know how often you get follow-ups to these sorts of things, but I thought I would let you know the outcome.

As a former emergency medical technician instructor, I evaluated the situation as not needing an ER. It clearly was not an anaphylactic reaction and also did not appear to be an infection. On further research the symptoms were consistent a calculus in the parotid.

I made an appointment with an ENT the following morning but could not be seen until yesterday (Wednesday). By midday Monday the swelling, including in response to eating, had largely subsided, with only a small amount of residual inflammation. By my Wednesday appointment it was almost gone.

The ENT concluded that it was a small calculus that had passed on its own and confirmed that there was no infection. As of today I am completely symptom free.

Thanks for your assessment on Sunday. That particular disorder was one with which I was unfamiliar.

thank you.
As I said, it could be a stone that can block the gland,.
These can become infected so the stone should be removed.
The ENT is the correct doctor to be seeing to do this.
Glad that it was not infected.
Good luck.
And again thanks for the follow up.