Abstract
Acute suppurative parotitis is rare in neonates, typically unilateral, and linked to risk factors like prematurity. We report an extremely rare case of acute bilateral suppurative parotitis in a 10-day-old, full-term male neonate who lacked established risk factors, being exclusively breastfed without dehydration. The patient presented with fever and rapid bilateral parotid swelling. Initial labs showed leukocytosis and elevated CRP, but serum amylase was notably low, confirming its limited diagnostic utility in newborns. Due to rapid clinical deterioration despite empirical intravenous antibiotics (vancomycin/meropenem), bilateral incision and drainage were performed on day three. Drainage culture confirmed Staphylococcus aureus. The infant recovered completely after the surgical intervention and a 10-day antibiotic course. This case highlights the exceptional presentation of bilateral involvement and the absence of common risk factors in a full-term infant, emphasizing the need for prompt surgical drainage when antibiotics fail.