TY  - CHAP
M1  - Book, Section
TI  - Acute Inflammatory Salivary Gland Disorders
A1  - Lustig, Lawrence R.
A1  - Schindler, Joshua S.
A2  - Papadakis, Maxine A.
A2  - McPhee, Stephen J.
A2  - Rabow, Michael W.
A2  - McQuaid, Kenneth R.
PY  - 2022
T2  - Current Medical Diagnosis & Treatment 2022
AB  - Acute  bacterial  sialadenitis  most  commonly  affects  either  the  parotid  or  submandibular  gland.  It  typically  presents  with  acute  swelling  of  the  gland,  increased  pain  and  swelling  with  meals,  and  tenderness  and  erythema  of  the  duct  opening.  Pus  often  can  be  massaged  from  the  duct.  Sialadenitis  often  occurs  in  the  setting  of  dehydration  or  in  association  with  chronic  illness.  Underlying  Sjögren  syndrome  and  chronic  periodontitis  may  contribute.  Ductal  obstruction,  often  by  an  inspissated  mucous  plug,  is  followed  by  salivary  stasis  and  secondary  infection.  The  most  common  organism  recovered  from  purulent  draining  saliva  is  S  aureus.  Treatment  consists  of  intravenous  antibiotics,  such  as  nafcillin  (1  g  intravenously  every  4–6  hours),  and  measures  to  increase  salivary  flow,  including  hydration,  warm  compresses,  sialagogues  (eg,  lemon  drops),  and  massage  of  the  gland.  Treatment  can  usually  then  be  switched  to  an  oral  agent  based  on  clinical  improvement  and  microbiologic  results  to  complete  a  10-day  treatment  course.  Less  severe  cases  can  often  be  treated  with  oral  antibiotics  with  similar  spectrum.  Complete  resolution  of  parotid  swelling  and  pain  can  take  2–3  weeks.  Failure  of  the  process  to  improve  and  ultimately  resolve  on  this  regimen  suggests  abscess  formation,  ductal  stricture,  stone,  or  tumor  causing  obstruction.  Ultrasound  or  CT  scan  may  be  helpful  in  establishing  the  diagnosis.  In  the  setting  of  acute  illness,  a  severe  and  potentially  life-threatening  form  of  sialadenitis,  sometimes  called  suppurative  sialadenitis,  may  develop.  The  causative  organism  is  usually  S  aureus,  but  often  no  pus  will  drain  from  Stensen  papilla.  These  patients  often  do  not  respond  to  rehydration  and  intravenous  antibiotics  and  thus  may  require  operative  incision  and  drainage  to  resolve  the  infection.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1184157307
ER  -