Sialadenitis

Overview

Sialadenitis (bacterial infection of a salivary gland) Sialadenitis is a painful infection that usually is caused by staphylococcus, streptococcus, Haemophilus influenzae or anaerobic bacteria. Although it is very common among elderly adults with salivary gland stones, sialadenitis also can occur in infants during the first few weeks of life. Many things increase the risk of this condition, including dehydration, recent surgery, prematurity, malnutrition, eating disorders, chronic illness, cancer, medications (antihistamines, diuretics, psychiatric medications, beta-blockers, barbiturates), Sjgren's syndrome and certain occupations (trumpet playing, glass blowing). Without proper treatment, sialadenitis can develop into a severe infection, especially in people who are debilitated or elderly.

Symptoms

Symptoms may include a tender, painful lump in the cheek or under the chin; a foul-tasting discharge of pus from the duct into the mouth; and in severe cases, fever, chills and malaise (a generally sick feeling).

Prevention

You can lower your risk of viral infections of the salivary glands by being immunized against mumps and influenza. Although there are no specific guidelines to protect against other types of salivary gland disorders, it is helpful to do the following: * Avoid smoking. * Eat a healthy diet. * Drink six to eight glasses of water daily to avoid dehydration. * Practice good oral hygiene, with regular tooth brushing and flossing.

Diagnosis

After you describe your symptoms, the doctor will review your medical history, smoking history, current medications and diet. The doctor also may ask whether you: * Have recently been hospitalized for surgery, because decreased intake of food and liquids after surgery can increase the risk of salivary gland stones and infections * Have ever received radiation treatments for cancer of the head or neck * Were ever diagnosed with mumps or immunized against mumps * Have recently been exposed to anyone with the flu or another viral illness * Have any autoimmune condition, such as rheumatoid arthritis Next, your doctor will examine your head and neck, including the area inside your mouth. The doctor will press gently on areas of your cheeks and jaw to feel for lumps, areas of tenderness and salivary gland stones. Then, depending on your symptoms, history and physical findings, the doctor may order one or more of the following tests: * X-rays to detect salivary gland stones * Magnetic resonance imaging (MRI) or computed tomography (CT) scans to check for tumors and for stones that are not visible on X-rays * A fine-needle aspiration (using a thin needle to remove cells from the salivary gland) to determine whether a tumor is cancerous * Sialography, in which dye is injected into the gland's duct so that the pathways of saliva flow can be seen * Blood tests to measure antibodies against specific viral infections or autoantibodies for Sjgren's syndrome * A salivary gland biopsy (removal of a small piece of tissue) to diagnose a cyst, tumor, or Sjgren's syndrome * A salivary function test to help diagnose Sjgren's syndrome * Blood tests to check for nutritional or hormonal problems that can cause sialadenosis * Special eye tests to look for evidence of Sjgren's syndrome

Prognosis

With prompt antibiotic treatment, the prognosis is usually very good. The highest risk of complications is in elderly people and those with chronic, debilitating illnesses.

Treatment

Treatment includes drinking fluids or receiving fluids intravenously (through a vein); antibiotics; warm compresses on the infected gland; and encouraging saliva flow by chewing sour, sugarless candies or by drinking orange juice. If these methods do not cure the infection, surgery can be done to drain the gland.