Acute sialadenitis is an acute inflammatory process that is localized in the salivary gland and is caused by viruses or bacteria that exert their effect against the weakening of the immune defense of the human body. Among the entire pathology of the salivary glands, acute and chronic inflammation accounts for about 55%.
- 1 What are the different types of sialadenitis depending on the cause of the disease?
- 2 What are the clinical features of acute viral sialadenitis?
- 3 Video on the symptoms of mumps
- 4 Features of inflammation of the salivary gland caused by the influenza virus
- 5 What are the clinical features of acute post-infection and postoperative bacterial sialadenitis?
- 6 What are the characteristics of lymphogenous sialadenitis?
- 7 What are the clinical features of contact sialadenitis?
- 8 How does inflammation of the salivary gland come about when it enters a foreign body?
- 9 What are the main principles of treatment of acute bacterial sialadenitis?
What are the different types of sialadenitis depending on the cause of the disease?
All acute inflammatory processes in the salivary glands are divided into:
- Acute inflammatory process caused by viruses( mumps, influenza, cytomegalovirus, herpes viruses, Coxsackie, Eckho, etc.);
- Acute sialadenitis, which causes bacteria. There are several types of bacterial inflammation:
- Postoperative sialadenitis, which develops after surgery on the gland for any pathology( such as salivary gland adenoma );
- Postinfectious, which occurs against the background of having an acute infectious disease;
- Lymphogenous when there is a drift of bacteria inside the organ along with the lymphatic fluid;
- Contact, in which the entry of pathogenic microorganisms occurs from nearby tissues( phlegmon next to the gland);
- Acute sialadenitis caused by the ingress of a foreign body into the organ duct.
What are the clinical features of acute viral sialadenitis?
The most frequently occurring inflammation of the salivary gland is caused by paramyxovirus and influenza virus.
The effect of paramyxovirus leads to the development of an infectious disease called epidemic parotitis. The source of infection in this pathology will be a sick person, infection occurs by airborne droplets. The virus most often affects the large salivary glands, mostly the parotid.
The duration of the incubation period is about three weeks. The disease begins with general symptoms, patients complain of weakness, muscle and headaches, decreased appetite, sleep disturbance. Quite often dry mouth is characteristic. At first, fevers are not noticed, then the body temperature rises to febrile figures. In the course of the disease, both salivary glands are most often involved in the pathological process, they increase in size, become dense and painful. Over the next three days, the swelling continues to increase, then for another four days it remains sufficiently pronounced, the reverse development of the inflammatory process slowly occurs in the next ten days. Also, a clinical sign of the disease is the swelling of the tissues surrounding the inflamed gland, which reaches up to the eye at the top, and below it descends to the neck. The skin over this swelling becomes tense and shiny, but does not blush. For mumps, three points are characteristic, with pressure on which the pain will be felt: the point in front of the earlobe, the tip of the tubercle behind the ear on the side of the lesion, and the point in the lower jaw from below. A characteristic of this form of the disease is that even with its severe course, the nearest lymph nodes hardly increase. The severity of the inflammatory process decreases after six days.
Treatment of this form of sialadenitis is complex and depends on the severity of the disease. Specific therapy is not, the main thing in the fight against the virus will be compliance with the diet( balanced and caloric) and strict bed rest( at least 10 days).On the area of the affected gland superimposed dry compresses, prescribe physiotherapy. In case of secondary infection, antibacterial drugs are used. With the development of an abscess, surgical therapy is indicated.
Video on the symptoms of mumps
Features of inflammation of the salivary gland caused by the influenza virus
The influenza virus most often affects the parotid glands, simultaneously on both sides. Often, both the submandibular glands are involved. There are three degrees of severity of the disease: light, medium and heavy. The disease begins acutely, with a sharp rise in temperature, the appearance of signs of intoxication and deterioration of well-being. The affected gland increases in volume, becomes dense, the edema of tissues, its surrounding develops. There is pain when trying to open your mouth and turn your head. If the submaxillary glands are affected, then there is difficulty and pain in the act of swallowing. Also, there is a sharp violation of the salivary glands function, dryness in the mouth appears. In the case of a severe course of the disease, an abscess may develop. A feature of sialadenitis caused by the influenza virus is that the disappearance of acute symptoms of the disease occurs within seven days, and the elimination of edema and the normalization of the gland function takes several weeks.
What are the clinical features of acute post-infection and postoperative bacterial sialadenitis?
The most common cause of this form of the disease is the infectious process occurring in the body, the postoperative period, general exhaustion, cardiac failure( heart failure) and other diseases. Pathogenic microorganisms enter the body through the duct of the salivary gland, either through blood or lymph fluid. The factor that facilitates the penetration of microbes is a reduction in the formation and saliva secretion, which occurs reflexively in various infections and operations on the abdominal organs. Pathogenic microorganisms causing acute sialadenitis are most often streptococci( Peptostreptococcus magnus, Streptococcus pyogenes).
Inflammation can be serous or purulent, sometimes necrosis of the body is possible. Parotid glands are most often affected. The disease begins acutely, characterized by a rapid increase in the symptoms of inflammation. Typically, an increase in parotid gland in the volume, it becomes dense to the touch, pain appears, some lobules melt, and pus begins to appear from the duct. The surrounding organ of the tissue swells.
What are the characteristics of lymphogenous sialadenitis?
In the case of the development of this type of sialadenitis, parotid glands and lymph nodes are located in them. Most often, the inflammation is localized only on one side, the source of microbes will be the ongoing pathological processes of the pharynx, nose, tongue, teeth, cheeks. The disease begins gradually, within two weeks there is an appearance and enlargement of a dense site in the thickness of the gland, which is painful and prevents the person from opening his mouth. The color of the skin over this place remains unchanged for a long time.
In the future, there are three possible options for further development of the process:
- In the absence of pus in the lymph nodes, timely treatment and elimination of the causative factor, the inflammatory focus is resolved. However, this happens quite slowly, the infiltrate resolves for at least three weeks. Throughout this period, a small amount of a transparent discharge is released from the duct of the affected gland;
- In this case, the affected lymph node rotates inside the salivary gland, the formation of an abscess and its opening into the duct. In this case, pus is released from the discharge hole, and salivary gland tumor begins to gradually decrease( the infiltrate resolves).The formation of an abscess occurs slowly enough and is often accompanied by no significant changes in the patient's condition. During this period of the disease, it can be detected not a strong decrease in the formation of saliva, it can be cloudy or viscous;
- With this variant of the disease, the inflammatory process spreads to the entire salivary gland, up to the skin. At the same time the organ swells and becomes painful, the skin over it blushes. Very often an abscess forms in the gland.
Treatment of inflammation of the salivary gland ( lymphogenous) is carried out by the earliest possible elimination of the factor that caused the development of the disease. In the absence of suppuration, therapeutic measures consist in stopping inflammation and normalizing the process of saliva secretion. If the abscess develops, it is removed by opening the abscess.
What are the clinical features of contact sialadenitis?
This form of the disease occurs then, then the inflammation spreads to the parotid salivary gland from the chronic infectious focus that exists for a long time next to it. The source of infection can be carious tooth, osteomyelitis of the lower jaw, festering cyst. In this case, the tissues of the organ are affected and acute inflammation develops, which then becomes chronic.
How does inflammation of the salivary gland come about when it enters a foreign body?
Most often in the stream fall: straw, blade of grass, tooth fragment, toothbrush set, fish bone. The moment when a foreign body enters the gland, almost all patients remember it. The main clinical sign of this form of pathology is a violation of salivary secretion. Then the inflammatory process develops in the duct wall, which passes to the gland tissue. A characteristic feature of this form of the disease is that very often the melting of the organ capsule and the spread of inflammation to the surrounding tissues occurs. Also, often around the foreign body formed salivary stone.
Treatment of this form of sialladen operative.
What are the main principles of treatment of acute bacterial sialadenitis?
Therapy of this form of the disease is complex and includes general and local methods:
- Antibacterial drugs that penetrate well into the salivary gland( spiramycin, rovamycin, amoxicillin);
- Flushing of the ducts of the gland( with purulent discharge from them) with solutions of antibiotics or antiseptics( furacillin);
- In order to reduce the intensity of the inflammatory process, once-daily blocking of Novocain blockades;
- Medical compresses on the affected area;
- Physiotherapeutic methods of treatment;
- In case of abscess development - surgical therapy.