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Acute Suppurative SialoadenitisAka: Obstructive Sialadenitis, Bacterial Sialoadenitis, Supprative Parotitis, Acute Parotitis, Parotitis

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  1. Pathophysiology
    1. Most common in age >50 years
      1. Contrast with Viral Sialoadenitis
    2. Parotid Gland is most commonly affected Salivary Gland
      1. Less bacteriostatic secretions than submandibular
    3. Usually due to bacterial infection
      1. Staphylococcus aureus (most common)
      2. Streptococcus species
      3. Gram Negative Bacteria
      4. Anaerobic Bacteria
  2. Risk Factors
    1. Advanced age
    2. Volume depletion
    3. Anticholinergic Medications causing Xerostomia
    4. Secondary to Salivary Gland Calculus
      1. Known as Obstructive Sialadenitis
  3. Symptoms
    1. Acute pain localized over affected Salivary Gland
    2. High fever with chills often present
  4. Signs
    1. Ill appearing patient
    2. Tender, swollen Salivary Gland (usually Parotid Gland)
    3. Regional Lymphadenopathy
    4. Pus at affected Salivary duct orifice
      1. Parotid duct (Stensen's Duct) at upper second molar
      2. Submandibular duct (Wharton's Duct) at frenulum
  5. Labs
    1. Gram Stain and culture of Salivary duct discharge
  6. Radiology
    1. CT Scan if not improving within 3-4 days
    2. Avoid sialography in acute bacterial Sialoadenitis
  7. Differential Diagnosis
    1. See Lymphadenopathy of the Head and Neck
    2. Sialolithiasis
  8. Management
    1. Start antibiotic coverage for Staphylococcus aureus
      1. Dicloxacillin
    2. Increase Saliva production
      1. Increase fluid intake
      2. Lemon drops to increase Saliva secretion
      3. Stop anticholinergics and other Xerostomia causes
    3. Symptomatic therapy
      1. Analgesics
      2. Warm compresses over affected Salivary Gland
      3. Attempt to milk gland of discharge
    4. Otolaryngology consultation
      1. Early surgical drainage is often required
      2. Also indicated if no improvement in 3-4 days
  9. References
    1. Fedok in Noble (2001) Primary Care Medicine, p. 1770-1
    2. Chow in Mandell (2000) Infectious Disease, p. 699-700
    3. Walner in Cummings (1998) Otolaryngology, p. 5-121

Mumps (C0026780)

Definition (MSH)An acute infectious disease caused by RUBULAVIRUS, spread by direct contact, airborne droplet nuclei, fomites contaminated by infectious saliva, and perhaps urine, and usually seen in children under the age of 15, although adults may also be affected. (From Dorland, 28th ed)
Definition (CSP)acute, inflammatory, contagious disease caused by Rubulavirus and characterized by swelling of the salivary glands, especially the parotids, and sometimes of the pancreas, ovaries, or testes; spread by direct contact, airborne droplet nuclei, fomites contaminated by infectious saliva, and perhaps urine.
ConceptsDisease or Syndrome (T047)
ICD9072, 072.9
BasqueGOLOA
DanishFaresyge
DutchBof
Englishepidemic parotiditis, Epidemic Parotitides, EPIDEMIC PAROTITIS, Infectious parotitis, Mumps, Mumps parotitis, Parotitis
FinnishSIKOTAUTI
FrenchOreillons
GermanMumps
Hungarianparotitis epidemica
ItalianOrecchioni
NorwegianKUSMA
PortugueseParotidite epidemica/papeira
Spanishfiebre urliana, paperas, parotiditis, parotiditis epidémica, parotiditis epidemica, Parotiditis epidemica/paperas, parotiditis infecciosa, parotiditis urliana
SwedishPASSJUKA/PAROTITIS
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Obstructive sialadenitis (C0149773)

ConceptsAnatomical Abnormality (T190)
EnglishObstructive sialadenitis, Salivary gland obstruction
Spanishobstrucción de glándula salival, obstruccion de glandula salival, sialoadenitis obstructiva
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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