Sialadenitis – Treatment, Symptoms, Radiology, ICD-10, Pathology, Antibiotics

Key Facts

• Sialadenitis is an inflammation of the salivary glands, which produce saliva, an essential fluid for oral health
• It can result from bacterial or viral infections, obstructions, or autoimmune conditions
• Patients may experience pain, tenderness, redness, and swelling over the affected gland, often accompanied by fever
• Treatment ranges from antibiotic therapy, hydration, warm compresses, and, in some cases, surgical intervention
• Proper oral hygiene and regular dental check-ups can significantly reduce the risk of developing sialadenitis

What is Sialadenitis?

Sialadenitis, at its core, is the inflammation of one or more of the salivary glands. The human mouth houses three primary salivary glands: the parotid, submandibular, and sublingual glands. Any of these can be affected by sialadenitis, but it most commonly strikes the parotid and submandibular glands.
Inflammation of these glands can cause a myriad of uncomfortable symptoms and can arise from various causes. While this condition can be alarming due to the discomfort and visible swelling it might produce, understanding its nature and the available treatments can offer patients peace of mind.
The role of our salivary glands is essential. They produce saliva, which aids in digestion, keeps our mouth moist, and plays a crucial role in maintaining oral health by washing away food particles and reducing the risk of tooth decay. Thus, any condition that affects these glands can have broader implications for our oral health and overall well-being.

Who gets Sialadenitis?

Sialadenitis can affect individuals of any age group, but the risk factors and predispositions vary:

• Age: Elderly individuals have a higher risk due to decreased salivary flow and the potential for dehydration, making the glands more susceptible to bacterial infections.
• Individuals with salivary stones or sialoliths: These stones can block the ducts of the salivary glands, leading to stagnation of saliva and subsequent bacterial growth.
• People with compromised immune systems: Those with chronic illnesses, undergoing chemotherapy, or on medications that reduce immune response may be more susceptible.
• Patients on certain medications: Some drugs reduce salivary flow, increasing the risk of bacterial overgrowth in the gland.
• Individuals with poor oral hygiene: An increased bacterial load in the mouth can potentially lead to bacterial migration into the salivary ducts.

Is Sialadenitis Serious?

While sialadenitis is primarily an inflammatory condition, it can become serious if not addressed promptly:

• Bacterial infections: If caused by bacteria and left untreated, the infection can abscess or even spread to surrounding tissues and spaces in the neck or into the bloodstream.
• Chronic sialadenitis: Repeated episodes can lead to fibrosis (scarring) of the gland, affecting its function and potentially leading to chronic pain and recurrent infections.
• Potential for tumor masking: Rarely, a tumor within the gland can present similarly to sialadenitis. If an inflammatory condition does not resolve with standard treatments, further investigations should be pursued.

What are the Symptoms of Sialadenitis?

The symptoms of sialadenitis are often localized to the affected salivary gland but can also produce systemic symptoms:

• Pain and tenderness over the affected gland, worsening during meals when the gland is stimulated to produce saliva.
• Swelling of the affected gland, which can be significant and cause visible enlargement on one side of the face or neck.
• Redness and warmth overlying the inflamed gland.
• Pus drainage in the mouth, if there’s an associated bacterial infection.
• Fever and chills, especially if the condition is due to a bacterial infection.
• Dry mouth or a gritty feeling due to reduced salivary flow.
• Bad taste in the mouth, often described as foul or bitter, especially if pus drains into the oral cavity.

Recognizing these symptoms early and seeking appropriate medical attention can ensure prompt treatment, reducing the risk of complications and ensuring the salivary gland’s preservation and function.

What Causes Sialadenitis?

Sialadenitis is an inflammatory condition of the salivary glands, and several factors can contribute to its onset:

• Bacterial Infections: The most common cause of acute sialadenitis is bacterial infection, particularly by Staphylococcus aureus or various strains of streptococcus. These bacteria can enter the ducts of the salivary glands, leading to inflammation.
• Salivary Gland Stones (Sialolithiasis): These calcified structures can block the salivary ducts, causing a buildup of saliva which can lead to bacterial overgrowth and subsequent inflammation.
• Reduced Salivary Flow: Conditions or medications that reduce the flow of saliva can predispose to sialadenitis. This includes dehydration, autoimmune conditions like Sjogren’s syndrome, or medications such as antihypertensives, antihistamines, and some psychiatric drugs.
• Viral Infections: Viruses like mumps, coxsackie, or the influenza virus can infect salivary glands leading to inflammation.
• Autoimmune Conditions: Some autoimmune conditions can result in inflammation of the salivary glands as seen in Sjogren’s syndrome.

Is Sialadenitis Contagious?

Sialadenitis itself is not contagious. However, if the condition is caused by a contagious viral or bacterial agent, that agent can be transmitted. For instance, the mumps virus, which can cause viral sialadenitis, is contagious. Standard precautions such as hand hygiene, not sharing personal items, and avoiding close contact can help prevent the spread of infectious agents.

How is Sialadenitis Diagnosed?

The diagnosis of sialadenitis typically involves a combination of clinical assessment and investigations:

• Clinical Examination: The physician will evaluate the patient’s medical history, symptoms, and physically examine the affected gland for signs of inflammation, tenderness, and swelling.
• Imaging:
  • Ultrasound: A non-invasive tool to visualize the salivary glands, assess the swelling, and detect stones or abscesses.
  • Sialography: An X-ray of the salivary ducts using a contrast dye to check for blockages.
  • MRI or CT Scan: Used in more complicated cases or when tumors are suspected.
• Microbiological Analysis: If an infection is suspected, a sample of the saliva or pus may be taken for culture to identify the causative organism and its antibiotic sensitivity.
• Blood Tests: To check for signs of infection, such as an increased white blood cell count or to assess for autoimmune markers if conditions like Sjogren’s syndrome are suspected.

Prompt diagnosis ensures appropriate treatment, preventing complications and preserving the function of the affected salivary gland.

How Do You Get Rid of Swollen Salivary Glands?

Swollen salivary glands can result from several factors, including infection, obstruction, or systemic diseases. Here’s how they are typically addressed:

Antibiotics

If the swelling is due to a bacterial infection, antibiotics are prescribed. The choice of antibiotic often depends on the specific bacteria identified. It’s important to complete the full course of antibiotics even if symptoms improve before the medication is finished.

Home Remedies

• Warm Compresses: Applying warm compresses can reduce pain and swelling.
• Saline Gargles: Saltwater rinses can help in keeping the mouth clean and may reduce discomfort.
• Sour Candies or Lemon: Consuming sour candies or lemon can stimulate saliva production, which can help flush out any blockages.

Nonsurgical Treatments

• Massage: Gentle massage in the direction of the ductal opening can help in expressing saliva and clearing potential blockages.
• Sialagogues: These are agents that stimulate saliva production. Lemon drops or certain medications might be prescribed.
• Ductal Probing: In cases where a stone or other obstruction is suspected, a physician might probe the duct to help clear it.

Surgical Treatments

• Stone Removal: If a salivary gland stone is identified and is causing a blockage, it may need to be surgically removed.
• Gland Excision: In recurrent or severe cases, it might be necessary to surgically remove the affected salivary gland.
• Drainage: If an abscess (a pocket of pus) has formed, it might need to be surgically drained.

How Long Does It Take to Recover from Sialadenitis?

Recovery from sialadenitis largely depends on the cause and the treatment provided:

• Bacterial Infection: With antibiotic treatment, symptoms usually start to improve within a few days. Complete recovery typically occurs within 7 to 10 days.
• Viral Infection: Viral infections can take a bit longer, possibly a couple of weeks, to resolve fully.
• Obstructive Sialadenitis: If the cause is an obstruction, such as a stone, and it’s successfully removed or cleared, symptoms can improve within days.
• Surgical Treatments: Recovery from surgical interventions varies. For minor surgeries, like stone removal or drainage of an abscess, recovery might take a few days to a week. For more extensive surgeries, like gland excision, the recovery could extend to several weeks.

Regardless of the cause or treatment, it’s important to follow up with a healthcare provider to ensure complete resolution and to address any potential complications.

Can Sialadenitis Go Away on Its Own?

Sialadenitis, especially when caused by viral infections or minor blockages, might resolve on its own. However, bacterial infections typically require antibiotic treatment to clear up. If left untreated, especially the bacterial form, sialadenitis can lead to abscess formation, spread of the infection, or chronic inflammation of the gland. It’s essential to see a healthcare professional if you suspect you have sialadenitis to get an accurate diagnosis and appropriate treatment.

How Can I Reduce My Risk for Sialadenitis?

• Good Oral Hygiene: Regularly brushing and flossing your teeth can prevent infections that could spread to the salivary glands.
• Stay Hydrated: Drinking plenty of water ensures continuous saliva flow, which can help prevent blockages in the salivary ducts.
• Avoid Tobacco: Smoking or chewing tobacco can reduce saliva production and can increase the risk of infections.
• Regular Dental Check-ups: Regular visits to the dentist can help catch and address potential issues early.
• Balanced Diet: Ensure you’re getting all the necessary nutrients and vitamins that promote overall health.

What Can I Expect If I Have Sialadenitis?

If diagnosed with sialadenitis, you can expect:

• Pain and Swelling: The affected salivary gland will be tender and swollen.
• Potential Fever: Especially if there’s an infection.
• Treatment: Depending on the cause, treatment might include antibiotics, measures to stimulate saliva flow, or even surgical interventions.
• Follow-ups: It’s essential to have follow-up visits with your healthcare provider to ensure the condition is resolving.
• Possible Recurrence: In some individuals, sialadenitis might recur, especially if there’s an underlying predisposition, like salivary gland stones.

Is Sialadenitis Fatal?

Sialadenitis itself is not typically fatal. However, if left untreated, especially the bacterial form, it can lead to severe complications like the spread of the infection to other areas, abscess formation, or chronic sialadenitis. In rare circumstances, untreated infections can spread to the bloodstream, leading to sepsis, which can be life-threatening. It’s crucial to seek medical care and follow prescribed treatments to avoid these potential complications.

When Should I See My Healthcare Provider?

You should see your healthcare provider if you notice:

• Prolonged Swelling: Any swelling of a salivary gland that doesn’t resolve in a couple of days
• Pain: Pain in the mouth or face that is persistent or worsening
• Fever: Especially if it’s accompanied by facial swelling or pain
• Dry Mouth: A sudden decrease in saliva production
• Difficulty Eating or Talking: Due to pain or swelling
• Pus: If you notice pus or any other discharge from the duct of a salivary gland

When Should I Go to the ER?

While many cases of sialadenitis can be managed by your primary healthcare provider, there are certain situations where it’s crucial to seek emergency care:

• High Fever: A very high fever accompanying facial swelling.
• Difficulty Breathing: Swelling that is causing difficulty breathing or swallowing.
• Severe Pain: Especially if it’s preventing you from eating or drinking.
• Rapid Onset: Symptoms that appear and worsen quickly.
• Signs of Spreading Infection: Such as red streaks radiating from the area of swelling, or a feeling of overall illness.

Sialadenitis ICD-10 Code

ICD-10-CM Diagnosis Code for Sialoadenitis is K11.20.

List of approximate synonyms:

• Infective sialoadenitis
• Parotitis
• Sialoadenitis
• Sialoadenitis (infection of salivary gland or duct)
• Sialoadenitis of the submandibular gland
• Sialoadenitis, infectious
• Submandibular sialoadenitis

Bottom Line

Sialadenitis is an inflammation of the salivary glands that can be caused by a range of factors, from infections to blockages. While it’s not typically a life-threatening condition, it’s essential to get a proper diagnosis and treatment to prevent complications. If you experience symptoms of sialadenitis, seek guidance from a healthcare provider. In severe cases, or if symptoms rapidly worsen, it’s crucial to seek emergency care. With proper treatment, most individuals recover without long-term complications. Regular dental check-ups and good oral hygiene practices can help in preventing this condition.

This article is complete and was published on October 25, 2023, and last updated on October 25, 2023.