How is acute sialadenitis managed?

Updated: May 12, 2020
  • Author: Adi Yoskovitch, MD, MSc; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Acute sialadenitis

  • In cases of acute sialadenitis, adequate hydration should be ensured and electrolyte imbalances corrected.

  • Patients are most often treated on an outpatient basis, with the administration of a single dose of parenteral antibiotics in an emergency department, followed by oral antibiotics for a period of 7-10 days. Clindamycin (900 mg IV q8h or 300 mg PO q8h) is an excellent choice and provides good coverage against typical organisms.

  • Patients who exhibit significant morbidity, are significantly dehydrated, or are septic should be admitted to hospital. In this latter group of patients, CT scanning of the area should be performed. If a large abscess is noted, incision and drainage should be considered. Small abscesses typically respond to conservative methods.

  • In cases refractory to antibiotics, viral and atypical bacterial causes should be considered.


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