sialadenitis

Sialadenitis is inflammation of one or more salivary glands, most often the parotid or submandibular glands. It can be acute or chronic and results from infection, ductal obstruction, autoimmune disease, or, less commonly, trauma or irradiation. Acute bacterial sialadenitis is the most common form and is often linked to reduced saliva flow from dehydration or illness.

Clinical features include a tender, swollen gland, fever, and pain that may worsen with meals. Purulent discharge from the duct supports infection. Viral parotitis, such as mumps, can also cause parotid swelling with fever and malaise.

Common causes are bacterial infection, typically Staphylococcus aureus, and ductal stones (sialolithiasis) causing obstruction. Other factors include dehydration, postoperative states, autoimmune diseases such as Sjögren’s syndrome, and less often radiation-induced changes.

Diagnosis is clinical and supported by imaging. Ultrasound is often used to detect stones and ductal dilation; CT or MRI may be employed for complicated cases. Purulent saliva can be cultured. Blood tests may show inflammation, and autoimmune workup may be indicated if an autoimmune disease is suspected.

Treatment depends on cause. Acute bacterial sialadenitis is usually treated with antibiotics effective against Staphylococcus aureus, such as amoxicillin-clavulanate; alternatives are used for penicillin allergy. Supportive measures include hydration, gland massage, sialogogues, and warm compresses. Obstructive stones may require stone removal or ductal dilation; recurrent or chronic disease may need specialist evaluation.

Prognosis is generally favorable with prompt treatment. Complications can include abscess, ductal stenosis, fistula, or, rarely, sepsis. Conditions that predispose to recurrence include persistent obstruction or dehydration.