Sialadenitis is an infection of the salivary glands. It is usually caused by a virus or bacteria. The parotid (in front of the ear) and submandibular (under the chin) glands are most commonly affected.
Symptoms and Signs
Fever, chills, and unilateral pain and swelling develop. The gland is firm and diffusely tender, with erythema and edema of the overlying skin. Pus can often be expressed from the duct by compressing the affected gland and should be cultured. Focal enlargement may indicate an abscess.
· Antistaphylococcal antibiotics
· Local measures (eg, sialagogues, warm compresses)
Initial treatment is with antibiotics active against S. aureus (eg, dicloxacillin, 250 mg poqid, a 1st-generation cephalosporin, or clindamycin), modified according to culture results. With the increasing prevalence of methicillin-resistant S. aureus, especially among the elderly living in extended-care nursing facilities, vancomycin is often required. Hydration, sialagogues (eg, lemon juice, hard candy, or some other substance that triggers saliva flow), warm compresses, gland massage, and good oral hygiene are also important. Abscesses require drainage. Occasionally, a superficial parotidectomy or submandibular gland excision is indicated for patients with chronic or relapsing sialadenitis.