Salivary gland diagnoses: Difference between revisions

Revision as of 03:16, 22 April 2013

Development of a calcium carbonate and calcium phosphate stone in a stagnant salivary duct
>80% occur in the submandibular gland

Pain, swelling, and tenderness may resemble parotitis
- Sialolithiasis is exacerbated by meals and may develop over course of minutes when eating
Typically unilateral
A stone may be palpated within the duct and the gland is firm

Tintinalli

Authors:

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 ==[[Suppurative Parotitis]]==
-===Background===
-*Serious bacterial infection of parotid gland that occurs in pts w/ decreased salivary flow
-**Caused by retrograde migration of oral bacteria into salivary ducts and parenchyma
-**Usually caused by staph, strep, anerobes
-*Risk factors:
-**Dehydration
-**Prematurity or advanced age
-**Sialolithiasis
-**Oral neoplasms
-**Salivary duct strictures
-**Meds (cause systemic dehydration or decrease salivary flow)
-***Diuretics
-***Antihistamines
-***TCAs
-***B-blockers
-**Chronic illnesses
-***HIV
-***Sjogren syndrome
-***Anorexia/bulimia
-===Clinical Features===
-*Rapid onset
-*Skin over parotid gland is red and tender
-*Purulent drainage from Stensen's duct
-*Fever
-*Trismus
-===Treatment===
-#Hydrate the volume-depleted patient
-#Massage and apply heat to the affected gland
-#Stimulate salivation using sialagogues such as lemon drops
-#Abx
-##PO abx if pts can tolerate oral liquids and have no evidence of systemic illness
-##Amoxicillin-clavulanate OR clindamycin OR cephalexin + metronidazole
-##IV abx
-###Indicated for trismus, inability to tolerate oral liquids, or immunocompromised
-###Nafcillin OR ampicillin-sulbactam OR (vancomycin + metronidazole (if MRSA suspected))
 ==[[Sialolithiasis]]==