Inflammatory Patterns and Lymphoma

Inflammation of the salivary glands can take several different forms: acute or chronic sialadenitis, lymphoepithelial lesions, or granulomatous disease. Acute sialadenitis is usually a bacterial inflammation of the salivary glands that most commonly affects the parotid gland. The serous nature of the parotid gland saliva, which is less antimicrobial than mucinous saliva, makes it more susceptible to this process. Acute sialadenitis tends to occur more often in individuals who are older and/or medically debilitated, and it is especially common as a postoperative complication. Other causes of acute sialadenitis include stenosis of the salivary duct system due to trauma or sialolithiasis. Importantly, neoplastic conditions can also lead to duct obstruction with accompanying acute and/or chronic sialadenitis. In contrast to older adults, children with acute sialadenitis are affected by the less clinically aggressive nonsuppurative acute parotitis secondary to infection with paramyxovirus (mumps). Most cases of acute sialadenitis in adults result from oral bacterial infection of the salivary ducts. The bacterial causes of acute sialadenitis include Staphylococcus aureus, Streptococcus spp., and Haemophilus influenzae. Patients with acute sialadenitis present with acute onset of pain, swelling, fever, and chills and are managed aggressively, which includes antimicrobial therapy as a cornerstone of the treatment. Untreated suppurative parotitis can be associated with several severe medical complications and even death.