Bacterial Infection of Salivary Glands

Bacterial Infection of Salivary Glands 

        1. Acute bacterial sialadenitis. 

        2. Chronic sialadenitis. 


                                 1.   Acute bacterial sialadenitis 

•        Causes 

             Ductal  obstruction can be caused by  sialolithiasis, congenital  strictures, or compression by an adjacent tumor.

             Decreased salivary flow can result from dehydration, debilitation or medications.

             Recent   surgery   because   the   patient   has  been   kept   without   food   or   fluids   and   has

                received medications that produce xerostomia.

•      Type of involved bacteria 

             Most cases are due to Staphylococcus aureus.

             They also may arise from streptococci or other organisms.

             The organism reach the gland from the oral cavity through the duct.

•       Clinically 

             Most common in the parotid gland and may be  bilateral (acute suppurative parotitis).

             The  affected gland is swollen and painful  and  the overlying  skin may be erythematous.

             Low-grade fever may be present.

             Trismus.

             A purulent discharge  often  is  observed  from the duct orifice when applying  digital  pressure.

•  Histopathologic features 

             Accumulation of neutrophils is observed within the ductal system and acini.

                               2. Chronic sialadenitis 

     Recurrent or persistent ductal obstruction (most commonly caused by sialoliths) can lead to

        a chronic sialadenitis.

•     Clinically 

             Periodic swelling and pain occur within the affected gland.

             Swelling usually develop at meal time when salivary flow is stimulated.

             Chronic sialadenitis can affect the parotid gland, submandibular gland, or the minor  salivary                            glands.

•   Histopathologic features 

             Accumulation of chronic inflammatory cells (lymphocytes and plasma cells) within

                the ductal system and acini.

             Atrophy of the acini is common.

             Salivary gland fibrosis may occur.

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