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Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
Salivary gland infections
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Salivary gland infections

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Clinical Microbiology …

Clinical Microbiology
Fifth Year

Published in: Health & Medicine, Technology
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  • 1. Salivary gland infections • • • • • • • • Introduction Different Types of infections – Bacterial, Viral Pathogenesis – etiology Microbiology(bacteria) Signs and Symptoms Management Complications Prevention
  • 2. Salivary Glands • There are 3 paired salivary glands in humans 1. Parotid - largest of the major salivary glands Two Lobes divided by facial nerve 2. Submandibular deep to mylohyoid, superficial to hyoglossus 3. Sublingual - Smallest of the salivary glands • Common surgical disease; infection/calculi
  • 3. Salivary glands
  • 4. Salivary gland infections • Viral - Mumps (commonest) • Bacterial - Acute parotitits - Chronic parotitis - Recurrent parotitis of childhood - Submandibular sialadenitis - Tuberculosis - Actinomycosis
  • 5. Factors in salivary gland infections Oral microorganisms Reduced salivary flow Drugs - opiates, irradiation Sjogren’s syndromme Dehydrtion Abnormal gland architecture Sialoths(stones) Strictures Sialectasis Salivary gland infection
  • 6. Acute bacterial parotitis • Pathogenesis - Retrograde infection in reduced salivary flow - Local abnormalities in gland architecture • Microbiology - Staph aureus, - Streptococci (alpha hemolytic) - Haemophylus species are the common ones isolated. • Exact causative organism is difficult to isolate as sample collection is difficult.
  • 7. Symptoms • Redness (erythma) over the side of the face or the upper neck • Swelling in pre and post auricular areas extending to angle of mandible • Breathing or swallowing difficulty (these may be emergency symptoms). • Extreme mouth or facial pain especially when eating
  • 8. Symptoms • • • • • Thick purulent discharge (pus) on milking. Dry mouth, Fever with chills,. Abnormal tastes, foul tastes Decreased ability to open the mouth Swelling of the face (particularly in front of the ears, below the jaw, or on the floor of the mouth)
  • 9. Investigations • WBC COUNT - Leucocytosis • Milk the exact pus from gland and do culture and sensitivity, Gram stain. • X- ray or CT scan or ultrasound may be done if there is an abscess.
  • 10. Management • Warm salt water rinses (1/2 teaspoon of salt in 1 cup of water) may be soothing and keep the mouth moist. • Massaging the gland with heat may help. • Hydration- Drink lot of water and use sugar-free lemon drops to increase the flow of saliva and reduce swelling. • If there is an abscess, surgery to drain it or aspiration may be done.
  • 11. Management • Appropriate antibiotic therapy (Flucloxacillin, Erythromycin) • Severe cases - Antibiotics +surgical intervention • Treat the cause – Sialography (imaging) stones or strictures, any abnormalities. • Sialography is contraindicated in acute infection.
  • 12. Possible Complications • Abscess of salivary gland • Infection returns • Spread of infection (cellulitis, Ludwig's angina)
  • 13. Chronic bacterial parotitis • • • • Recurrent episodes of parotitis Persistent infection Damaged glands (Sjogren’s syndrome) Clinical course - intermittent exacerbations and remissions • Destroys the gland • Parotidectomy for long term infection and good results
  • 14. Recurrent parotitis of childhood • Repeated acute episodes of painful enlargement of one or both parotid glands. • Etiology - Unclear, • Suggested congenital abnormalities of ductal system( mumps, foreign bodies, trauma from orthodontics) • Most will resolve by puberty, Remove identified predisposing factor, Antibiotics.
  • 15. Prevention • Good oral hygiene may prevent some cases of bacterial infection. • Drink plenty of water, keep mouth wet.
  • 16. Uncommon infections • Tuberculosis secondary to pulmonary infection. • M. tuberculosis and Atypical mycobacteria • Rarely seen • Parotids are commonly affected • C/F - Firm non tender swelling, rarely facial paralysis. • Management – Skin tests, ATT.
  • 17. Uncommon infections • ACTINOMYCOSIS • A.israeli is implicated. • Salivary glands may be infected in upto 10% of cervicofacial actinomycosis • MANAGEMENT – diagnose and treat.
  • 18. Mumps virus • Family-paramyxoviridae , genus - Rubulavirus • Mumps is acute contagious non suppurative inflammation on one or both salivary glands • Mild childhood disease with serious complications in adults • Humans are only the natural hosts • 1/3 of infections are asymptomatic
  • 19. Pathogenesis • Acquired via repiratory route by saliva and respiratory secretions • Replicate in respiratory epithelium • Viremia spread virus to salivary gland • Virus is present in saliva 2 days before and 9 days after salivary gland swelling • Infect kidney, viruria may persist 2 wks
  • 20. Clinical presentation  IP= 2-4wks  1/3 are asymptomatic  Prodromal period  Malaise, nausea  Painful swelling of parotid glands (50% of cases) unior bilateral  Aseptic meningitis (15%)  Meningoencephalitis (0.3%)
  • 21. Clinical presentation • Unilateral deafness (5/100,000) • Orchitis (20-50%) of males affected – Painful swelling – Rarely sterility • Oophoritis (5%) of females affected • Pancreatitis (4%)
  • 22. Diagnosis • Virus isolation – Saliva, CSF, urine within few days of illness – Monkey kidney cells – Shell vials, 2-3 day IF • Serology – 4x rise in Ab in paired serum – IgM detection ELISA

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