Salivary Gland Infections Flashcards
What are the 5 potential causes of salivary gland swelling?
- Inflammatory causes
- Obstructive causes
- Metabolic causes
- Tumours
- Drug or food hypersensitivity
What are the potential inflammatory causes of salivary gland swelling?
- Acute bacterial infection
- Viral infections
- Chronic infections (e.g.: TB, actinomycosis)
- AI diseases (e.g.: Sjogren’s)
What are the potential obstructive causes of salivary gland swelling?
- Stones (sialadentits)
- Trauma
- Mucous retention (ranula)
What are the potential metabolic causes of salivary gland obstruction?
- Obesity
- Hypothyroidism
- Alcoholic Liver Disease
- Malnutrition (e.g.: eating disorder)
What are the tumours that could cause salivary gland swelling.
- Benign (e.g.: pleomorphic adenoma, monomorphic adenoma)
- Malignant (e.g.: mucoepidermoid carcinoma, lymphoma, adenoid cystic carinoma)
What bacteria is acute suppurative sialadenitis (including parotitis) caused by?
Usually caused by staph aureus, but in adults, it can occasionally be polymicrobial.
What are the signs and symptoms of acute suppurative sialadenitis (including parotitis)?
- Enlarged glands (often hot and tense)
- Pus may be expressed from the gland duct
- Pt can be systemically unwell
- Dehydrated
- Difficulty swallowing
What is the management of acute suppurative sialadenitis (including parotitis)?
- Urgent referral to hospital for surgical review
- Rehydration
- Culture and susceptibility testing of blood samples
- Surgical or intraductal drainage if the swelling is fluctuant
- Antibiotic therapy (initially IV, then move to oral if Pt can swallow)
What is the usual IV antibiotic therapy for acute suppurative sialadenitis?
Flucloxacillin 2g IV 6 hourly.
What IV antibiotic therapy do you use for patients with risk of MRSA infection?
Vancomycin IV.
What is the oral antibiotic therapy for acute suppurative sialadenitis?
- Dicloxacillin 500mg 6 hourly for 10 days (IV plus oral).
OR
- Flucloxacillin 500mg 6 hourly for 10 days (IV plus oral)
