What is Sialadenitis (Salivary gland infection)?

This condition is characterized by enlargement and inflammation of the salivary glands. There are three pairs of salivary glands: the parotids, submandibular and sublingual. The parotid glands are located in front of the ears. The submandibular is just underneath the mandible and the sublingual glands are located under the floor of the mouth. Sialadenitis most commonly affects the parotid glands. A salivary stone can usually contribute to an acute infection of the gland. This condition is most commonly seen in chronically ill and elderly individuals. The most common cause of Sialadenitis are bacterial infections especially caused by Staphylococcus aureus. Infections in the salivary glands are more likely to happen when there is a lack of saliva in the mouth. This could be due to poor fluid intake, diuretics, or Sjogren’s syndrome, which is an autoimmune disorder that causes dry eyes and dry mouth. 

What are the symptoms of Sialadenitis?

  • Pain and tenderness over the glands
  • Fever and chills
  • Pus coming out the gland ducts 
  • Swelling of the gland and tissue around it
  • Redness

How is Sialadenitis diagnosed?

Your healthcare professional will mostly base their diagnosis on your history and symptoms. A CT, ultrasound, and/or MRI can confirm Sialadenitis when it can’t be clinically diagnosed. These imaging tests are able to detect a salivary stone causing an obstruction or a tumor. If there is pus coming of the gland duct it is recommended to be sent for culture and analysis. 

What are the differential diagnoses of Sialadenitis?

  • Salivary gland tumor
  • Facial cellulitis
  • Dental abscess
  • Lymphadenopathy 

How is Sialadenitis treated?

To treat Sialadenitis it is recommended to maintain hydrated or to eat salivating foods such as sour candy, sugarless gum, or ice chips. If infected, the initial treatment is dicloxacillin 250 mg four times a day or clindamycin. If a MRSA infection is suspected especially in the elderly population then vancomycin is used. Warm compresses can also be applied to the area and a gland massage could be done to expulse a salivary stone. If there is an abscess present, then drainage is required. For chronic or reoccurring Sialadenitis a gland excision could be suggested. 

For more information about salivary gland infections please visit the John Hopkins Medicine website.

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