Bacterial sialoadenitis in children: clinical presentation and therapeutic approach.

Abstract

Bacterial sialoadenitis is an inflammation of the salivary glands, commonly the parotid gland, caused mainly by Staphylococcus aureus. It affects older adults, immunocompromised adults, and children aged 2 to 7 years. Decreased salivary flow is a predisposing factor, as well as dehydration, sialolithiasis, certain medications and poor oral hygiene. Other causative agents are Streptococcus viridans, Haemophilus influenzae and anaerobic bacteria. In children, immunological immaturity and habits such as thumb sucking or onychophagia favor retrograde colonization. It manifests with pain, increased glandular volume, fever and purulent discharge. Diagnosis is usually clinical, although it can be supported by ultrasound or tomography. Treatment includes antibiotics such as amoxicillin with clavulanic acid or clarithromycin, hydration, massage and, if required, drainage. Case report: 3.5-year-old boy with left preauricular swelling, fever, onychophagia and poor hygiene. Pus outflow through Stenon's duct was observed. Ultrasonography confirmed sialoadenitis. He was treated with clarithromycin, ibuprofen, fomentations, massages and sialagogues. After 15 days glandular functionality was recovered. Conclusion: This case shows the importance of timely diagnosis and comprehensive management, including medical treatment, follow-up and education to prevent recurrences.