MIDTERM 1 - part 2 (INFECTIOUS SIALADENITIS)

an acute viral sialadenitis that primarily affects the parotid glands.

Mumps

• The causative agent of mumps

• Transmission occurs by direct contact with _ _ with a 2- to 3-week incubation period preceding clinical symptoms.

• paramyxo virus

• salivary droplets

CLINICAL FEATURES

● Symptoms are _, _, _, , and _ _.

● _ swelling reaches its maximum in 2-3 days.

● _% of cases are _ involvement.

● Potentially serious complications (_ or _) can occur in adults.

● fever, malaise, headache, chills, and preauricular pain.

● Parotid swelling reaches its maximum in 2-3 days.

● 70% of cases are bilateral involvement.

● Potentially serious complications (orchitis or oophoritis) can occur in adults.

Mumps TREATMENT (4)

1. Bed rest

2. Analgesics

3. Corticosteroids may be used in severe cases.

4. Vaccine - given to infants at 12 to 15 months of age

-again at age 4 to 6 years old (highly effective at preventing the disease)

_ _ of salivary glands is rare and affects neonates due to transplacental infection.

Cytomegaloviral infection

Cytomegaloviral infection (or Sialadenitis) may cause: (3)

debilitation, developmental retardation, and premature birth.

CLINICAL FEATURES of Cytomegaloviral Sialadenitis

● In adults who are _, infection may cause _, salivary gland _, and other complications.

● _ can be a serious complication.

CLINICAL FEATURES of Cytomegaloviral Sialadenitis

● In adults who are immunocompromised, infection may cause fever, salivary gland enlargement, and other complications.

● Retinitis can be a serious complication.

TREATMENT of Cytomegaloviral Sialadenitis

• can be demonstrated in biopsy material.

• Ganciclovir may be used to control severe infections.

a multisystem granulomatous disease of undetermined origin

Sarcoidosis

Sarcoidosis - Intraoral manifestations presents _ _ of the buccal mucosa and vestibule.

nodular swellings

CLINICAL FEATURES of Sarcoidosis

● May affect individuals of what age? females OR males? blacks OR caucasians?

● May be associated with _ syndrome that causes _.

● _ swelling may occur unilaterally or bilaterally.

• May affect individuals of any age; females > males, blacks > caucasians.

• Heetfordt’s syndrome that causes xerostomia.

• Parotid swelling may occur unilaterally or bilaterally

TREATMENT of Sarcoidosis

● Biopsy is now used to confirm sarcoidosis

● No specific treatments.

● Corticosteroids and immuno modulating agents.

A generic term for a group of metabolic disorders that may cause salivary gland enlargement

sialadenosis or sialosis

(8) have been linked to this clinical salivary gland abnormality (Metabolic Conditions)

1. Chronic alcoholism

2. dietary deficiency

3. obesity

4. diabetes mellitus

5. hypertension

6. bulimia

7. anorexia nervosa

8. hyperlipidemia

(Metabolic Conditions)

In _ _, reduced flow rates have been reported in addition to bilateral parotid gland enlargement.

diabetes mellitus

(Metabolic Conditions)

In cases of type I _, this is characterized primarily by parotid enlargement with mild oral or ocular sicca symptoms.

type I hyperlipoproteinemia

Another endocrine-related salivary gland enlargement may be noted in

acromegaly

a systematic auto-immune disease.

Sjögren’s syndrome

CLINICAL FEATURES of Sjögren’s syndrome

● peak age of onset is _ years, and 90% of cases occur in _

● chief oral complaint is _ which puts the patient at greater risk for dental caries, periodontal disease, and oral candidiasis.

● Parotid gland enlargement, often bilateral, occurs in approximately _% of patients.

• 50 yrs, women

• xerostomia (dry mouth)

• 50%

TREATMENT of Sjögren’s syndrome

● Artificial saliva and oral lubricants as well as artificial tears

● Sialagogues may be used.

● Follow-ups with a dentist, ophthalmologist, and rheumatologist are important.

An uncommon cause of major salivary gland enlargement is the.. 

benign (salivary) lymphoepithelial lesion (BLEL).

Presents as a persistent, nonpainful, firm, unilateral or bilateral mass in a major salivary gland.

Salivary Lymphoepithelial Lesion (BLEL)

Salivary Lymphoepithelial Lesion (BLEL) TREATMENT

Treatment options include:

1. observation

2. repeated aspiration

3. sclerotherapy

4. radiotherapy

5. surgical treatment

a chronic autoimmune disorder that results in fibrosis and hardening of the skin.

Scleroderma (systemic sclerosis)

often occurs in conjunction with other autoimmune conditions such as rheumatoid arthritis, lupus erythematosus, dermatomyositis, and Sjögren’s syndrome.

Scleroderma (systemic sclerosis)