Sharp sialadenit – an inflammation of salivary gland which activators in most cases are viruses and bacteria. Patients complain of morbidity in the field of the struck gland, emergence of a swelling, dryness in a mouth, temperature increase, deterioration in the general state. Diagnostics includes collecting the anamnesis, fizikalny survey, ultrasonography of salivary glands, a sialografiya. Treatment of a sharp epidemic sialadenit symptomatic. At identification of a sharp sialadenit of a bacterial origin appoint antibacterial, antihistaminic, anti-inflammatory medicines. In case of an abstsedirovaniye opening of the purulent center is shown.
Sharp sialadenit – the inflammatory defeat of salivary glands which is followed by decrease in their sekretorny function. Most often diagnose sharp sialadenit priushny gland (parotitis) that is explained by an anatomic structure of its output channels, serous type of a secret. Less often submandibular salivary gland is involved in pathological process (submaksillit). Extremely seldom reveal sharp sialadenit hypoglossal area (sublingvit). The raised producing a mutsin submandibular and hypoglossal salivary glands is the good barrier interfering penetration of an infection through mouths of their output channels. The often sharpest sialadenit diagnose for children aged from 7 up to 15 years.
Reasons of a sharp sialadenit
The main activators of a sharp sialadenit – viruses and bacteria. At virus sialadenita infection happens in the airborne way. Sharp sialadenit bacterial genesis develops against the background of the reduced reactivity of an organism at patients with serious infectious diseases, diseases of cardiovascular system. At operations reflex reduction of salivation is observed that also creates favorable conditions for introduction and activization of bacterial agents. For this reason the disease is very often diagnosed for patients of infectious and surgical offices.
Carry to the local contributing factors promoting emergence of a sharp sialadenit striktura, anomalies of development of output channels, stones of salivary glands. Also introduction of a foreign matter in a channel gleam can initiate the beginning of development of an inflammation. Pyoinflammatory processes of adjacent fabrics are the reasons of a contact sharp sialadenit.
Development of a sharp sialadenit is preceded by decrease in secretion and oppression of a salivation therefore the barrier interfering penetration of an infection into gland parenchyma collapses. In an initial stage there is a serous inflammation. Further with strengthening of leykotsitarny infiltration sharp sialadenit can pass into a purulent form. Against the background of the reduced resilience of an organism fusion of the purulent centers develops that leads to emergence of sites of a necrosis.
Classification of a sharp sialadenit
On an etiology sharp sialadenita divide into 2 main categories:
- Virus. Causative agents of a disease – a paramiksovirusa, viruses of flu, herpes. A way of transfer – airborne. The Cytomegaloviral infection is transmitted gemotransfuzionno. Among sharp virus sialadenit the most known form is the epidemic parotitis caused paramiksovirusy.
- Bacterial. Develop against the background of the reduced resistance of an organism, after the postponed infectious diseases, surgeries. Also carry sharp to this group sialadenit a contact origin at which inflammatory process extends to gland from the nearby centers of defeat that is often observed at patients with phlegmon of priushno-chewing area, osteomyelitis.
In an inflammation form in stomatology allocate serous, purulent, gangrenous sialadenit. On character of a current distinguish easy, average weight and heavy degrees of a sialadenit.
Symptoms of a sharp sialadenit
Sharp epidemic sialadenit proceeds with the expressed clinic. At an easy form the insignificant swelling in priushny area is observed, the condition of patients is not broken. At medium-weight degree of a sharp sialadenit temperature increases. Dryness in a mouth is observed. At first one salivary gland swells up a little. Further the parenchyma of other gland also is involved in inflammatory process. The swelling is painful, a pasty consistence. Unpleasant feelings amplify during meal. The severe form of a sharp sialadenit is characterized by the expressed intoxication symptoms. Opening of a mouth painful. Salivation from the struck gland completely stops. Puffiness of fabrics extends up to an eye-socket, in the lower part goes down on area of a neck. At an epidemic sharp sialadenit risks of development of complications are high: pancreatitis, orkhit, meningitis.
Influenzal sharp sialadenit proceeds with involvement in inflammatory process of priushny glands. Sometimes pathological changes reveal in submandibular and hypoglossal areas. At a sharp sialadenit patients point to emergence of a swelling of a stony consistence in priushny sites, morbidity when opening a mouth. At a submaksillita there is pain when swallowing. At a sublingvita patients feel morbidity at the movements as language. Sharply the salivation decreases.
Sharp sialadenit a bacterial origin in most cases has secondary character. The main complaints come down to emergence of a painful swelling in a projection of the struck gland. The general state worsens, the hyperthermia develops. Upon transition of a catarrhal form of a sharp sialadenit in purulent of the mouth of a channel purulent contents are allocated. Skin becomes hyperemic. If sharp sialadenit resulted hit of a foreign matter to the canal of gland, the symptomatology begins to develop with salivary colic. Further the inflammation progresses with the advent of typical signs of a sharp sialadenit of bacterial genesis. Gangrenous sharp sialadenit arises at patients with the reduced immunity. The course of a disease sluggish, the clinic erased. Gradually gland necrosis with rejection of the struck fabrics develops.
Diagnostics of a sharp sialadenit
Diagnosis "sialadenit sharp" is based on a basis of complaints of the patient, the anamnesis of a disease, the yielded clinical examination, results of additional methods of a research. During fizikalny inspection of the patient with a sharp epidemic sialadenit the dentist reveals painful, is more often a bilateral swelling of a pasty consistence in a projection of the struck glands. Fluctuation is absent. When pressing in the site of a corner of the lower jaw morbidity is noted that is one of patognomonichny symptoms of a disease. At survey of mucous reveal the second characteristic sign of a sharp epidemic sialadenit – hyperaemia of gland, mucous around the mouth of an output channel.
At a sharp influenzal sialadenit diagnose existence of a painful swelling of a stony consistence with a hilly surface. Salivation is lowered. Rassasyvaniye of infiltrate is observed during a long interval of time. At a sharp bacterial sialadenit from a channel of the struck gland muddy saliva with pus impurity is emitted. At development of a purulent form of a sharp sialadenit skin over a swelling becomes hyperemic, shines. The mouth of an output channel towers over surrounding mucous. Dense sharply painful infiltrate is noted. There is perifokalny hypostasis.
At patients with a sharp bacterial sialadenit in blood test reveal acceleration of SOE, the increased quantity of leukocytes, shift of a leykotsitarny formula to the left. Emergence of the same sort of changes in blood in patients with a sharp epidemic sialadenit speaks about development of complications owing to accession of a secondary bacterial infection. Specific tests for definition of a paramiksovirus are reactions of braking of hemagglutination, binding of a complement. At a purulent sialadenit the contrast sialografiya is not carried out. For diagnosing of the inflammatory process caused by introduction of a foreign matter carry out ultrasonography of salivary glands, a sialografiya.
At diagnosis it is necessary to differentiate among themselves different forms of a sharp sialadenit, and also to carry out differential diagnosis of a disease with inflammatory processes of maxillofacial area: aggravation of a chronic sialadenit, abscesses, phlegmons, sharp lymphadenitis, Gertsenberg's pseudo-parotitis. Sharp sialadenit it can be revealed by the stomatologist, the pediatrician, the therapist, the infectiologist.
Treatment of a sharp sialadenit
Etiotropny treatment of a sharp epidemic sialadenit does not exist. At identification of symptoms of a disease symptomatic therapy is shown. For the purpose of increase in local factors of protection carry out irrigations of an oral cavity by interferon. For prevention of accession of a bacterial infection (that is often observed against the background of the expressed kserostomiya) resort to introduction of antibiotics in the mouth of an output channel. At identification of medium-weight and heavy forms of a sharp sialadenit treatment is performed in the conditions of a hospital of infectious office.
Upon transition of a sharp sialadenit to a purulent phase opening of the pathological center is shown. Apply dry compresses, bandages with a dimethyl sulfoxide on area of gland to normalization of sekretorny function, acceleration of a rassasyvaniye of infiltrate. At a sharp bacterial sialadenit appoint antibiotics (macroleads, penicillin). If from a channel pus is emitted, instillations of antibiotics and proteolytic enzymes are shown. At patients with a sharp purulent sialadenit apply inhibitors of proteases to suppression of production of kallikrein.
For the purpose of knocking over of inflammatory process appoint novokainovy medical blockade, put compresses with a dimethyl sulfoxide, and also with additives antihistaminic, anesthetics. At emergence of the centers of purulent fusion surgery is shown. Apply to elimination of morbidity, normalization of sekretorny function lazero-or magnetotherapy. Treatment of a gangrenous sialadenit, and also the sharp sialadenit caused by introduction of a foreign matter, surgical.
At a sharp sialadenit forecast favorable. Recovery occurs within 2 weeks. In the absence of the timely qualified treatment of a sharp sialadenit risks of development of the heavy complications which are followed by permanent decrease in a salivation, scarring, irreversible necrotic changes of the struck salivary glands increase.