Sialadenitis (sialoadenitis) is inflammation of salivary glands, usually the major ones, the most common being the parotid gland, followed by submandibular and sublingual glands. It should not be confused with sialadenosis (sialosis) which is a non-inflammatory enlargement of the major salivary glands.Sialadenitis can be further classed as acute or chronic. Acute sialadenitis is an acute inflammation of a salivary gland which may present itself as a red, painful swelling that is tender to touch. Chronic sialadenitis is typically less painful but presents as recurrent swellings, usually after meals, without redness.Causes of sialadenitis are varied, including bacterial (most commonly Staphylococcus aureus), viral and autoimmune conditions. Types
Acute
Predisposing factorssialolithiasis
decreased flow (dehydration, post-operative, drugs)
poor oral hygiene
exacerbation of low grade chronic sialoadenitisClinical featurespainful swelling
reddened skin
edema of the cheek, periorbital region and neck
low grade fever
malaise
raised ESR, CRP, leucocytosis
purulent exudate from duct punctum

Chronic
Clinical featuresunilateral
mild pain / swelling
common after meals
duct orifice is reddened and flow decreases
may or may not have visible/palpable stone. Parotid gland
recurrent painful swellings
Submandibular gland
usually secondary to sialolithiasis or stricture

Signs and Symptoms
Sialadenitis is swelling and inflammation of the parotid, submandibular, or sublingual major salivary glands. It may be acute or chronic, infective or autoimmune. Acute
Acute sialadenitis secondary to obstruction (sialolithiasis) is characterised by increasingly, painful swelling of 24–72 hours, purulent discharge and systemic manifestations. Chronic
Chronic sialadenitis causes intermittent, recurrent periods of tender swellings. Chronic sclerosing sialadenitis is commonly unilateral and can mimic a tumour. Autoimmune
Autoimmune sialadenitis (i.e Sjogren’s syndrome) causes unilateral or bilateral painless swellings unless there is a secondary infection. Infection
The most common salivary gland infection is mumps.
May have acute onset and may have a history of repeated episodes. 4. Recurrent painful swellings – indicative of chronic recurrent sialadenitis, may have similar signs and symptoms to an acute episode. 5. Pus exudation from salivary gland openings – indicative of bacterial infection, may occur on manipulation of the affected gland or spontaneously. Other common diagnostic factors to consider
1. Episodic swelling during meal times – may present as an acute salivary gland swelling without visible salivary flow from ductal openings. While palpation of affected glad may reveal an indurated salivary gland and presence of a sialolith. 2. Use of xerostomic medications – these medications will result in a decreased salivary flow rate which can predispose to infections of glands. Examples of medications that may contribute to this include antihistamines, antidepressant, and anticholinergic agents. 3. Recent surgical intervention under general anaesthetic – this could predispose to sialadenitis due to direct effects of anaesthetic agents used and volume depletion from surgery. 4. Dry eyes and mouth – dryness affecting the eyes and oral cavity are key symptoms of Sjogren’s syndrome and may be seen in combination with a connective tissue disease such as rheumatoid arthritis, scleroderma, or dermatomyositis. 5. Oral candidiasis – may be present in cases of Sjogren’s syndrome or in associate with a connective tissue disorder. Key factors to also consider which are less common
1. Mandibular trismus – restricted mouth opening to its full extent (of approximately 40mm) may be present with large swellings typically due to acute bacterial infection of affected gland. 2.