Sialadenitis - acute or recurrent

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to the referral standards and include:

  • Salivary gland swelling associated with eating
  • Dental caries
  • Trauma
  • Tender salivary gland
  • Calculus may be palpable in floor of mouth on bimanual palpation
  • Palpate floor of mouth for stones and record findings
  • Observe for purulent discharge from salivary duct when palpating gland
  • Evaluate mass for swelling, tenderness and inflammation

Tests

  • Ultrasound
  • Consider CT scan neck after the acute infection resolves
  • Occlusal view of floor of mouth for calculi
  • Culture or purulent discharge in mouth

Interim/GP management

To refer a patient with this condition, please see the ENT clinic page for the full referral process and templates.

Management:

  • Assess patient hydration and treat
  • Anti Staphylococcal antibiotics: Augmentin/Flucloxacilline ± Flagyl

For more information please see the Tasmanian Health Pathways website.

Emergency

If non-resolving despite medical therapy – refer immediately to ED

Abscess formation – immediate referral to ED

Urgent / category 1

If associated with hard mass, contact ENT OPD – Cat 1.

Poor antibiotic response within one week of diagnosis – contact ENT OPD – Cat 1.

Hard mass present – neoplasm?

Semi-urgent / category 2

If recurrent salivary gland swelling

Calculi suspected on exam, x-ray or ultrasound – Cat 2/3, depending on circumstances

Routine / category 3

Recurrent sialadenitis – Cat 3

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment