Concept

Sialadenitis

Summary
Sialadenitis (sialoadenitis) is inflammation of salivary glands, usually the major ones, the most common being the parotid gland, followed by submandibular and sublingual glands. It should not be confused with sialadenosis (sialosis) which is a non-inflammatory enlargement of the major salivary glands. Sialadenitis can be further classed as acute or chronic. Acute sialadenitis is an acute inflammation of a salivary gland which may present itself as a red, painful swelling that is tender to touch. Chronic sialadenitis is typically less painful but presents as recurrent swellings, usually after meals, without redness. Causes of sialadenitis are varied, including bacterial (most commonly Staphylococcus aureus), viral and autoimmune conditions. Predisposing factors sialolithiasis decreased flow (dehydration, post-operative, drugs) poor oral hygiene exacerbation of low grade chronic sialoadenitis Clinical features painful swelling reddened skin edema of the cheek, periorbital region and neck low grade fever malaise raised ESR, CRP, leucocytosis purulent exudate from duct punctum Chronic sclerosing sialadenitis Clinical features unilateral mild pain / swelling common after meals duct orifice is reddened and flow decreases may or may not have visible/palpable stone. Parotid gland recurrent painful swellings Submandibular gland usually secondary to sialolithiasis or stricture Sialadenitis is swelling and inflammation of the parotid, submandibular, or sublingual major salivary glands. It may be acute or chronic, infective or autoimmune. Acute sialadenitis secondary to obstruction (sialolithiasis) is characterised by increasingly, painful swelling of 24–72 hours, purulent discharge and systemic manifestations. Chronic sialadenitis causes intermittent, recurrent periods of tender swellings. Chronic sclerosing sialadenitis is commonly unilateral and can mimic a tumour. Autoimmune sialadenitis (i.e Sjogren’s syndrome) causes unilateral or bilateral painless swellings unless there is a secondary infection.
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