Parotid Mass: Epstein-Barr Virus and Facial Paralysis

Infectious mononucleosis is a common diagnosis in the pediatric and young adult population. Symptoms include low grade fever, malaise, odynophagia, and cervical lymphadenopathy. Neurological manifestations are uncommon, but include cranial nerve neuropathies. We describe a case of infectious mononucleosis in a pediatric patient who presented with a parotid mass and facial nerve palsy. Diagnosis was confirmed with a monospot test and Epstein-Barr virus antibody panel. The patient was managed conservatively with near total recovery of facial nerve function. This case demonstrates the need to consider infectious etiology prior to surgical intervention of a pediatric patient with facial nerve paresis and a parotid mass.