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osomop 4th > salivary gland infections? > Flashcards

salivary gland infections? Flashcards

1
Q

what are the two types of salivary gland infections ?

A

> bacterial infections

> viral infections

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2
Q

what are the general features of bacterial salivary gland infections?

A

> not as common as viral infections however not uncommon

> affects all age groups

> endogenous opportunistic infection

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3
Q

what are the common bacteria that cause bacterial salivary gland infections?

A

> Staphylococcus aureus

> Steptococci

> Some anaerobes

> Usually mixed infection

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4
Q

what are the predisposing factors of bacterial salivary gland infections?

A

> Any process that reduces salivary gland flow

> Any process that reduces host immunity

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5
Q

what pathogenies of bacterial salivary gland infections?

A

> Reduced salivary flow permits ascending infection from the mouth

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6
Q

what are examples of predisposing factors?

A

> Local duct obstruction – see later

> Previous radiotherapy

> Sjogrens syndrome

> Systemic drug therapy

> Immunosuppressants

> Dehydration

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7
Q

what is the onset like in a B SGI?

A

> gradual over a view days

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8
Q

what is the duration of a B SGI?

A

> may become persistent

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9
Q

what is a B SGI unilateral or bilateral?

A

> unilateral

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10
Q

is a B SGI recurrent? (frequency)

A

> yes it may be

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11
Q

what sites are affect by a B SGI?

A

> one major salivary gland

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12
Q

do you experience systemic upset during a B SGI?

A

> no

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13
Q

what are the clinical features of a bacterial salivary gland infection?

A

> Painful gland swelling

> Pus expressed from duct

> May have regional lymphadenopathy

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14
Q

how do you diagnose a bacterial salvary gland infection?

A

> Clinical findings

> Culture of microorganisms

> Plain radiographs

> Exclude other causes

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15
Q

what is the management of a bacterial salivary gland infection?

A

> Antibiotic therapy

> Ensure adequate hydration

> Consider predisposing factors

> Review

> Specialist referral if recurrent / signs of spreading infection

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16
Q

what antibiotic therapy is used for treatment of bacterial salivary gland infections?

A

> Initially empirical prescription (one antibiotic to cover a wide range of bacteria)

> May need to be revised in light of microbiological results

> Suggested protocol – co-amoxiclav 625mg (5 day course)

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17
Q

what are the causes of salivery obstruction?

A

> Benign Stricture

> Mucus plug

> Calculus (AKA sialolith or stone)
- Submandibular > Parotid

> Extraductal Compression

> obstruction increases the risk of infection due to reduced salivary flow

18
Q

how can you tell the difference between a salivary infection rather than an obstruction?

A

> Initially may cause symptoms of obstruction rather than acute infection, e.g. swelling at mealtimes that resolves over the next few hours

19
Q

what are sialoliths ?

A

> Sialoliths form by calcification of a mucus plug over time

> May be multiple, and within salivary gland duct or deep within gland itself

> usually sub mandibular

20
Q

how do you manage a sialoliths?

A

> Patient self management

> Removal in clinic using probe

> Lithotripsy (ultrasound)

> Basket retrieval (sialendoscopy)

> Excision

21
Q

what are are the complications of salivary gland infections?

A

> Recurrence of infection

> Spread of infection

> Fistula formation

> Compromised gland function

22
Q

what is sialogrpahy?

A

> An anatomical investigation of major salivary gland structure

> Specialist investigation

23
Q

what are the indications to use sialography?

A

> Obstructive symptomatology

> Sjogrens syndrome

24
Q

what is the technique for taking sialography?

A

> A radio-opaque dye is introduced into the gland via the duct

> Two radiographs at 90o to each other

25
Q

what are the contraindication to carrying out sialogrpahy?

A

> During acute phase of salivary gland infection

> Hypersensitivity to iodine

26
Q

what viruses may be present in patients ?

A

> herpes simplex

> HIV and hepatitis B may be present in the saliva of asymptomatic patients

27
Q

what are the general features of salivary gland infections?

A

> Common

> Occurs via droplet spread

> Principally occurs in children

28
Q

what are the common viruses that causes viral salivary gland infections?

A

> Paramyxovirus

> Influenza virus

> Echo viruses

> Epstein Barr virus

29
Q

during removal of salvery stones do you suture?

A

> no as this could cause stricture

> encouraging the patient to drink lots of water

> leads to larger duct

30
Q

what is the pathogenesis behind viral salivary gland infections?

A

> virus enters and replicates in epithelial cells

31
Q

what is the onset of V SGI? (paramyxovirus)

A

> incubation period = 21 Days

32
Q

what is the duration of a V SGI? (paramyxovirus)

A

> two to three weeks

33
Q

is viral infections severe in salivary glands? (paramyxovirus)

A

> only 10% of cases are severe

34
Q

what’s the frequency of a V SGI? (paramyxovirus)

A

> once only infection

> if a person is immunosuppressed it can reoccur

35
Q

what sites are infected by a V SGI? (paramyxovirus)

A

> usually the parotid

> bilateral

36
Q

is there systemic upset in V SGI? (paramyxovirus)

A

> variable

> worse in adults

37
Q

what are the clinical features of viral salivary gland infections ? (paramyxovirus)

A

> “Mumps”

> Pyrexia

> Painful parotid swelling

> Regional lymphadenopathy

> Clear saliva expressed

38
Q

how do you diagnose viral salivary gland infections?

A

> clinical findings

> serological techniques (viral titres)/ PCR

39
Q

what is the management of viral salivary gland infections?

A

> Symptomatic treatment (hydration, pain relief)

> Review

40
Q

what are the complications of mumps? (paramyxovirus)

A

> More likely in adults

> Pancreatitis,

> orchitis

> oophoritis

> can affect fertility

41
Q

what are the public health aspects surrounding mumps?

A

> Endemic infectious disease, reportable condition, can be outbreaks

> Vaccination

osomop 4th (18 decks)

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