Salivary gland inflammation

What is a salivary gland inflammation?

Under a salivary inflammation, doctors understand an inflammation of the large salivary glands. These include:

• Parotid glands (Glandula parotidea): They produce an aqueous secretion.
• Lower jaw glands (Glandula submandibularis): They produce a slimy-watery secretion.
• Subginal glands (Glandula sublingualis): They produce a mucous secretion.

In addition to the large salivary glands there are about 1000 small glands that are distributed throughout the mouth and contribute to the production of saliva.

Inflammation of the parotid gland

Everything important for the inflammation of the parotid gland can be found in the article Parotitis.

Salivary gland inflammation: symptoms

One differentiates the acute from the chronic salivary inflammation. Acute sialadenitis often manifests with the following onset of symptoms (especially when triggered by bacteria):

• Pain
• Swelling of the gland
• pressure sensitivity
• hard, coarse consistency
• hot, red skin over the gland
• Fever, chills
• lymphadenopathy
• general malaise, fatigue

Possibly empties through the ducts into the oral cavity. The swelling and the pain of the gland increase during eating, because chewing stimulates the production of saliva. In about 80 percent of cases, salivary gland inflammation occurs on one side only.

Salivary gland inflammation: Symptoms of an acute viral infection

If viruses trigger an acute salivary gland inflammation, the symptoms start about one to two weeks after the infection (incubation period). In contrast to the bacterial infection, the outgoing secretion is rather watery and not purulent.

Salivary gland inflammation: signs of chronic inflammation

Chronic recurrent sialadenitis occurs slowly and in spurts. The gland is painfully swollen. Possibly, purulent or milky-grained secretion occurs. Most chronic salivary gland inflammation is one-sided. She can also switch between the pages.

Salivary gland inflammation: causes

The causes of salivary gland inflammation are manifold. While children are more likely to suffer from mumps virus-induced inflammation of the parotid gland, older people are more likely to suffer from recurring bacterial infections. Overall, sialadenitis can have the following causes:

• Reduced saliva production: especially in older people due to a low drinking volume or low appetite, alcohol abuse, salivary stones, tumors or scarred salivary ducts
• Lack of oral hygiene, rotten teeth, oral mucositis
• Medicines like antidepressants, diuretics, antihistamininka, beta blockers, calcium antagonists
• Autoimmune diseases such as Sjögren syndrome or Heerfordt syndrome
• Radiotherapy of the head and neck region or radioiodine therapy in thyroid disorders
• Disorders of the salt and water balance
• chronic diseases such as diabetes mellitus or AIDS

Especially when saliva production or salivation is disturbed, bacteria from the mouth can enter the ducts of the salivary glands. There they can multiply and cause inflammation. Among them are streptococci, staphylococci, Escherichia coli and Pseudomonas.

Viruses usually cause salivary gland inflammation by getting into the gland through the blood. Typical pathogens include the Eppstein-Barr virus, cytomegalovirus, mumps virus and influenza virus.

Salivary gland inflammation: diagnostics

If you have persistent swelling in the area of ​​your head or mouth, severe pain and additional symptoms, you should consult a doctor. An ear, nose and throat doctor is the right contact person for sialadenitis. Before he examines you, he first asks you in detail about your medical history (anamnesis). Possible questions are:

• Since when are you having those complaints?
• Are there triggers that aggravate the symptoms?
• Do you suffer from a chronic disease such as AIDS, diabetes mellitus or rheumatism?
• Do you regularly take medication?
• Did you have a radiation treatment of the head or neck?

Salivary Inflammation: Physical Examination

Subsequently, your doctor will examine you. First, he looks at the affected area. He watches for swelling or skin over the gland. Then he searches the oral cavity for redness of the ducts or pus. He also scans the salivary glands to detect any swelling or hardening. He can also try to eat out pus.

In the next step, your doctor may make a smear of the saliva and examine it for pathogens. In addition, a blood sample can be helpful. The so-called inflammatory parameters are determined in the laboratory. These include the C-reactive protein, the erythrocyte sedimentation rate and the white blood cell count (leukocytes). Based on these values, your doctor can determine if there is inflammation in your body.

Salivary gland inflammation: further investigations

The diagnoses of mumps and acute purulent salivary gland inflammation can usually be easily made due to the symptoms and medical history. In order to differentiate other causes, further examinations may be necessary, such as an ultrasound examination (ultrasonography), magnetic resonance imaging (MRI), computed tomography (CT) or endoscopy. At endoscopy, a tiny camera is pushed through the ducts of the glands. This way, the pathways and glands can be displayed, tissue samples taken and irrigations performed.

Salivary gland inflammation: therapy

The treatment of salivary gland inflammation depends on the cause. Bacterial infections are treated with antibiotics. They kill bacteria or inhibit their reproduction. In salivary gland inflammation, the active ingredients cefuroxime or clindamycin are often used. To specifically treat the bacteria, an antibiogram can be made indicating which antibiotics work best.

Antibiotics do not help against viruses. In a virus-induced salivary gland inflammation can only treat the symptoms (symptomatic therapy). The doctor prescribes, for example, painkillers that also have an anti-inflammatory or antipyretic effect, such as ibuprofen or acetaminophen. In addition, cool envelopes can relieve the pain.

Furthermore, it is advisable to eat saliva-stimulating foods such as sweets, chewing gum or lemon. In addition, you should pay attention to a good oral hygiene, drink a lot and prefer soft foods.

If an autoimmune disease is the cause of salivary gland inflammation, your doctor may prescribe glucocorticoids (cortisone). They suppress the immune system and thus inhibit the inflammatory response.

If medications are suspected of inducing salivary inflammation, their use should be discontinued if possible.

Salivary gland inflammation: prognosis

If the salivary gland is treated properly in time, it usually heals without consequences within a few days.

Without proper therapy, however, sialadenitis can recur. In such cases surgical removal of the gland may be the only treatment option. This is usually easily possible, because the other salivary glands form enough saliva. However, there is a high risk that the facial nerve will be injured during the procedure and then the affected half of the face can no longer or only partially be moved.

If a bacterial suppurative salivary gland infection is not treated, a purulent encapsulation (abscess) can form. This can break through into the mouth, ear canal or through the neck tissue to the outside. When the triggering bacteria enter the bloodstream, potentially life-threatening sepsis (“blood poisoning”) develops.

Remains a chronic Salivary gland inflammation If left untreated, the glandular tissue may scar or regress.