Salivary disorders (PEARLS)
| Sialadenitis |
Sialadenitis is a bacterial infection of a salivary gland usually caused by sialolithiasis which is an obstructing stone in the salivary gland
- Acute swelling of the cheek which worsens with meals
- etiology: S. aureus
- Affects the parotid or submandibular gland, occurs with dehydration or chronic illness (Sjogren syndrome), ductal obstruction
- Diagnose with CT, ultrasonography, or MRI
TX:
- IV antibiotics: Nafcillin
- Hydration, warm compresses, sialagogues (lemon drops), massage gland
- Oral antibiotics for less severe cases - Dicloxacillin, 1st gen cephalosporin, or clindamycin
- Resolves in 2-3 Wks
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| Parotitis (ReelDx) |
Mumps is caused by paramyxovirus. Likely in a child without a complete vaccination series
- Typically, it begins with a few days of fever, headache, myalgia, fatigue, and anorexia, followed by parotitis; the illness is usually self-limited
- In adult males look for an associated orchitis
- Viral infections associated with parotitis include influenza A virus, parainfluenza, adenovirus, coxsackievirus, Epstein-Barr virus (EBV), cytomegalovirus, herpes simplex virus, human immunodeficiency virus (HIV), and lymphocytic choriomeningitis virus
TX: Self-limiting treat with hydration and rest
- Vaccination is effective for prevention
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