Salivary

Acute Nonsuppurative Sialoadenitis

search

Acute Nonsuppurative Sialoadenitis, Viral Sialoadenitis, Acute Nonsuppurative Sialadenitis, Viral Sialadenitis, Acute Viral Sialadenitis

  • Epidemiology
  1. Common in children
    1. Mumps cases are in children under age 15 years in 85% of cases (typically unimmunized)
  2. Less common in adults
    1. Sialolithiasis, Bacterial Sialadenitis affect adults most commonly
  • Causes
  1. Mumps Parotitis
    1. Historically, the most common cause prior to Vaccination
      1. Incidence reduced by 99% following routine Vaccination
    2. Transmitted easily by airborne droplet spread
    3. Local pain and swelling of Parotid Glands (may start unilaterally, but is bilateral ultimately)
    4. Associated with Otalgia and Trismus
  2. Human Herpesvirus 6 (Roseola or Exanthem Subitum)
  3. Epstein-Barr Virus Infection (Mononucleosis)
  4. Coxsackievirus Infection and other enteroviruses
  5. Parainfluenza Virus
  6. Influenza A
  7. HIV Infection: Bilateral Benign Lymphoepithelial Cysts (Parotid Gland)
    1. Diffuse, bilateral cystic involvement of the major glands (esp. the Parotid Gland)
    2. Presents with gradual, non-tender enlargement
    3. Diagnosed by Ultrasound
  • Symptoms and signs
  1. Swollen, tender Salivary Gland
  • Labs
  1. Mumps Serology
  2. Consider Monospot (or EBV and CMV Serology)
  3. Consider HIV Test if risk factors
  • Management
  1. Hydration
  2. NSAIDs for analgesia
  • Course
  1. Mumps Parotitis resolves within 2 weeks
  • Complications
  1. See Mumps
  • Prevention
  1. MMR Vaccine is 88% effective in preventing Mumps
  • References
  1. Fedok in Noble (2001) Primary Care Medicine, p. 1770-1
  2. Chow in Mandell (2000) Infectious Disease, p. 699-700
  3. Walner in Cummings (1998) Otolaryngology, p. 5-121
  4. Kim (2024) Am Fam Physician 109(6): 550-9 [PubMed]
  5. Wilson (2014) Am Fam Physician 89(11): 882-8 [PubMed]