Treatment of inflammation and cysts of the salivary glands. Which doctor treats inflammation of the salivary glands

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The inflammatory process in the salivary gland, usually parotid, occurs in both adults and children. Based on the reasons that caused it, as well as the age of the patient, the course of the disease is accompanied by various symptoms and requires appropriate treatment. The scientific purpose of inflammation of the salivary gland is sialadenitis (in some editions, sialadenitis). The disease rarely affects the submandibular and sublingual glands, in its course it is chronic and acute.

The reasons

The main reason that causes inflammation of the salivary gland is the action of the infectious microenvironment that has entered its cavity. Pathogens are diverse, based on their type, the disease is:

Viral, developing with mumps or in a simple "mumps". This microenvironment is well transmitted through the air and causes high sensitivity of the salivary glands, therefore, when it enters through the respiratory tract, the virus quickly penetrates into the parotid gland, begins to multiply in it, which causes inflammation. The pathogen poses an additional threat to children - boys. Since its abundant reproduction can lead to damage to the structure of the testicles, which will be reflected in infertility in adulthood.

Photo 1. Location of the parotid salivary gland

bacterial, otherwise called non-specific. In this case, the microflora is introduced through the oral cavity or by entering it into the blood. The main causes of infection with a bacterial type of sialadenitis are:

Poor oral hygiene
Reactive obturation, when obstruction of the abdominal organs is observed, for example, as a result of surgery, the development of a malignant tumor, diseases of the gastrointestinal tract, stress, malnutrition, or exposure to diabetes mellitus. As a result of obstruction, the ducts narrow reflexively, due to which the volume of saliva secreted decreases and it accumulates at the place of production. All this creates a favorable environment for microorganisms from the oral cavity to take root and begin to multiply in the parotid gland.
Mechanical obturation, when the duct is blocked by a foreign object, such as a calculus. The result here is the same as with reactive blockage - the development of inflammation.

Infection through the blood is a rarer phenomenon, which is facilitated by the disease of typhoid fever and scarlet fever. In addition, sialadenitis can occur when a person has symptoms of pharyngeal inflammation, lesions on the mucous membrane in the mouth, signs of furunculosis, tonsillitis, periodontitis. These pathologies should not be ignored, if they are present, it is important to carry out qualified treatment in order to avoid complications.

Inflammation of the salivary gland is characterized by a rare phenomenon when the chronic form is not a continuation of the acute one. Sialoadenitis is primarily a chronic disease, because. the salivary gland in its structure is prone to a gradual change in the tissue structure. The main reasons why it becomes inflamed in some people and not in others is:

genetic features
Autoimmune abnormalities
Situations of high stress
hypothermia
Getting injured
Weakness of the body against the background of a serious illness

In older adults, chronic inflammation is more common than in children and young adults. This is due to atherosclerotic phenomena, due to which the blood supply and nutrition of the salivary gland deteriorates. Atherosclerosis occurs as a result of the aging of the body, when the vessels and arteries slowly wear out and lose their tone.

Symptoms and photos

The initial stages of inflammation of the salivary gland are manifested by very acute manifestations, most often in a person, the temperature rises sharply to values over 39 gr. The main external symptom is swelling in the area near the ears, which manifests itself symmetrically, which is accompanied by pain with increased chewing. Gradually, the swelling increases, and the swelling, spreading outward, becomes more expressive. More informative symptoms are presented in the photo.

Photo 2. Inflamed salivary glands in the mouth

With the development of the disease or if there is no adequate treatment, the disease also moves to the salivary glands under the tongue and lower jaw.

The presence of additional symptoms will depend on the type of inflammatory process, and if the disease is not treated, then it goes through several stages in turn:

Serous
Purulent
Gangrenous

At serous form of sialadenitis, in addition to swelling in the parotid area, there is dryness in the mouth. Pain sensations tend to increase when eating food or even when looking at it, when saliva is reflexively released. The skin in the parotid zone is not changed, if you press a little on the salivary gland, then there is almost no salivation.

Photo 3. External symptoms of inflammation

If there was a transition to purulent stage the pain becomes very severe. A person cannot sleep and eat normally, the temperature is stable, its value is >38 degrees. There are symptoms of restriction when opening the mouth, swelling is noticeable in the temples, cheeks and lower jaw. If you press on the area of swelling, which to the touch has a dense structure with a red skin tone and pain when touched, then a certain volume of purulent contents is released into the oral cavity.

Gangrenous form is very active and pronounced. The main symptoms are high fever, partial damage to the skin over the inflamed salivary gland, through which the dead parts of the organ are gradually released.

In some cases, the disease turns into the death of the patient, when the infection spreads uncontrollably, leading to sepsis in different parts of the body. Another cause of death is severe bleeding that occurs when cervical vessels are damaged. Thus, despite the small size of the salivary gland, the inflammatory process in it can result in the most serious consequences, so the disease must be treated. At the same time, amateur performance is not allowed, all treatment must take place within the framework of a medical institution.

If it has been inflamed submandibular salivary gland, then swelling occurs at its location. When palpating, an increase in size, tuberosity and severe pain are diagnosed. The progression of the disease causes pain when swallowing due to an increase in the area of edema. In the sublingual zone, redness and signs of swelling are noticeable, pus is sometimes released from the iron ducts.

Disease submandibular glands are often referred to as calculous. "Calculous" means a foreign object that overlaps something. In such conditions, small pebbles can block the salivary ducts. This is usually due to an increase in calcium levels. The calculous inflammatory process has symptoms:

A sharp stabbing sensation of pain that increases when taking food
Impaired salivation
Dryness in the mouth
Swelling and tuberosity in the submandibular area
Purulent discharge from under the tongue
An increase in the volume of the salivary gland during periods of eating, which is expressed by discomfort, and sometimes even does not allow you to eat normally

The sublingual salivary gland becomes inflamed in rare cases, most often it occurs against the background of an abscess or lesions of the teeth.

Chronic sialadenitis

Chronic disease takes many forms.

At chronic interstitial form parotid salivary gland is affected. Pathology is more typical for older people, especially for women. For a long period, any signs and manifestations are absent, as inflammation develops slowly, causing constriction of the ducts along the way.

A sharp increase in symptoms happens suddenly, its first sign is a dry mouth. At the same time, the gland itself acquires an increased size, becomes painful and smooth to the touch. After the exacerbation has passed, the size of the organ does not return to normal, remaining several times larger.

Chronic parenchymal inflammation almost in all cases concerns exclusively the parotid gland. In women, the risk of development is also higher than in men, there are no pronounced age groups susceptible to the disease, it occurs both in an infant and a very old man over 60-70 years old. Often there are no symptoms at all for many years.

The exacerbation resembles acute sialadenitis, when at the initial stage only a very large release of salty mucus is diagnosed, if you press on the salivary gland. Without treatment, a feeling of heaviness and increased density of the gland develop further, there are no symptoms of limited mouth opening. In the later stages, the surface becomes bumpy, there are no pain sensations, saliva is secreted with purulent phenomena, sometimes dry mouth is present.

Sialodochit call the state when the pathological process has touched only the ducts that are expanding. The disease is characteristic of both men. So are older women. The main symptom is increased salivation during eating or talking, which causes the skin surface around the mouth to swell. During an exacerbation, the salivary gland swells strongly, pus is released from it.

Diagnostics

Identification of an acute form of inflammation occurs during examination and questioning. Previously practiced sialography, which involves the introduction of a contrast agent. However, in the future, this diagnostic method was abandoned, since during an acute course it enhances the inflammatory process, which sharply increases pain.

Sialography is used in the diagnosis of chronic sialadenitis. If the disease is present, then the x-ray will show narrowing of the ducts and a small amount of contrast. A feature of the parenchymal form is a large number of cavities with a diameter of 6-9 mm, which in total include a large amount of contrast.

Treatment of inflammation of the salivary gland

If the patient has signs of acute inflammation, then the treatment is carried out in a hospital. The main therapy is conservative, surgery is resorted to only in a situation of purulent manifestations.

How to treat acute sialadenitis

At mumps treatment is prescribed based on the symptoms present. Interferon agents are mainly used, and the patient is also shown to be treated with antipyretic and analgesic drugs.

If revealed acute nonspecific inflammation salivary gland, then the treatment is aimed at eliminating the inflammatory reaction and returning the standard functionality of saliva secretion. The main therapy is:

The use of a salivary diet to train the muscular structure of the ducts through which saliva is excreted. Diet products include everything sour, such as lemon, cranberries, and crackers.
The introduction of antibiotics and antiseptics into the cavity of the duct, for example, penicillin and gentamicin, dioxidine and potassium furaginate.
The use of an anti-inflammatory compress based on a Dimexide solution, which anesthetizes and suppresses the progression of the disease.
Physiotherapy using UHF and warming.
Blockades based on novocaine and penicillin with severe edema and a sharp increase in inflammation.
Taking systemic antibiotics. Which antibiotics to choose the doctor decides after studying the bacterial environment.
Intravenous injections.

Surgery as a treatment is used in the purulent course of the disease. The gangrenous course is the most severe, it requires an urgent operation under general anesthesia. If the cause of the pathology is a calculus, then it must be removed, otherwise relapses will be repeated again.

How is a chronic condition treated?

In exacerbations, treatment is the same as in the acute form. In periods when there is no exacerbation, the chronic form is treated:

Massages of the ducts, when an antibiotic is additionally introduced into their cavity to combat purulent phenomena
Novocaine blockades, electrophoresis, which increase secretion
Daily galvanization course
The introduction of solutions that prevent the development of exacerbations
X-ray therapy, due to which the inflammation of the salivary gland is well stopped
Removal of the gland, the restoration of the functionality of which is impossible.

Which doctor treats

Profile doctors who treat sialadenitis are dentist or surgeon specializing in the facial and jaw area. When a person has symptoms of mumps, then for children the profile doctor is a pediatrician, and for adults - a therapist. The task of these broad specialists is to conduct an initial examination and refer them to a narrower doctor, for example, an infectious disease specialist who treats mumps.

Preventive measures

To prevent the occurrence of inflammation of the salivary gland, there are no special preventive measures associated with the introduction of the vaccine. The only exception is mumps, when a special vaccine is used, which is also used to protect against measles and rubella. This method of prevention is used for children, they are vaccinated at the age of about 18 months. The effectiveness of such vaccination is kept at the level of 95% and allows you to almost completely eliminate the occurrence of the disease.

Standard non-curative prophylaxis includes:

Compliance with oral hygiene
Timely cleansing of infectious foci in the mouth, often associated with caries and other dental lesions
Tracking congestion in salivation and preventing them by taking special medications (pilocarpine), rinsing with furacilin, rivanol and other antiseptics.

Human salivary glands are paired organs that play a significant role in the initial stages of food digestion, and also affect the mineral and protein metabolism in the body.

Salivary glands of man

There are three pairs of salivary glands:

parotid;
sublingual;
submandibular.

These glands produce up to two liters of oral fluid per day. It is very important for moisturizing the oral cavity and protecting against the introduction of pathogenic microorganisms into the mucous membrane, the breakdown of complex carbohydrates into simpler forms, and the excretion of certain medicinal substances.

Also, the parotid glands play the role of endocrine glands and affect the mineral and protein metabolism, due to the presence of a hormone-like substance, parotinin, in their secretions.

Saliva helps with proper articulation, unhindered passage of the food bolus into the throat, improves the taste perception of food and increases the body's resistance to infections with the help of lysozyme.

A bit of anatomy: the glands of the oral cavity.

The oral fluid contains proteins, more than 60 enzymes - amylase, mucin, glycoproteins, and immunoglobulins. In addition, the salivary fluid contains phosphatase, which is actively involved in calcium-phosphorus metabolism and helps the mineralization of bones and teeth.

For the state of health, not only the qualitative, but also the quantitative composition of saliva is very important. A small amount of saliva can cause various inflammatory diseases of the oral cavity, demineralization of tooth enamel, and its excessive production leads to dehydration and exhaustion of the body.

In addition to the large glands in the mouth, a person has many small salivary glands, which are grouped on the tongue, lips, cheeks, hard and soft palate. With inflammation of any of the salivary glands, the disease sialadenitis occurs.

Inflammation of the salivary glands

The most common etiological factors in the development of inflammation in the salivary glands is the penetration of an infectious agent through the ducts or by the hematogenous route. Most often, the parotid salivary gland is inflamed, and then the disease is called parotitis. Its infection occurs when the infection is introduced through the oral cavity, blood or lymph. Sometimes the cause of parotitis can be a foreign body in the ducts of the gland, such as stones. Let us consider in more detail the causes and symptoms of the development of epidparotitis.

Causes of inflammation of the parotid gland

The cause, as a rule, is an acute viral infection, which in most cases affects the parotid gland, the submandibular and sublingual glands rarely become inflamed.

This disease belongs to the group of childhood diseases and often occurs in the form of epidemic outbreaks among preschool groups. Most often it is transmitted by airborne droplets, but there are cases of household infection with the virus. The main age of patients is 5-10 years.

A timely visit to the doctor can save you from many problems.

It rarely happens in adults, but it is more difficult for them to tolerate and more often gives complications to various organs and systems. First of all, men fall into the risk zone, since the disease leads to infertility and testicular atrophy.

Clinical picture

From the moment of infection to a detailed clinical picture, about 2.5 weeks pass.

The disease can manifest itself in mild, moderate and severe forms. There are also complicated and uncomplicated forms. During the first 9 days, the person remains contagious.

The mild form of the disease is characterized by:

minor violation of the general condition;
often the process is one-sided;
the gland is not greatly enlarged, a transparent secret is secreted from it, it is almost painless on palpation;
on the side of the lesion, swelling is observed, which is almost imperceptible from the side.

All manifestations usually disappear within a week and do not give any complications.

The average form of parotitis

After the incubation period, a period of precursors begins, which lasts several days. During this period, a headache, malaise gradually develops, the temperature rises to subfebrile numbers. There is weakness, aching joints, muscle pain. There is dryness in the mouth.

Mumps, although it is not considered fatal, but still you should not neglect the disease, lethal cases are known.

The inflammatory process affects both parotid glands, they swell, become painful to the touch, swelling of the neck appears, and one side is enlarged more. Due to swelling of the neck and glands, the patient's ears rise and resemble the ears of a pig. That is why the people call the disease "mumps":

as the process develops, the body temperature rises, but it does not reach high numbers, but is limited to 38 ° C;
the oral cavity may be hyperemic, salivation is reduced;
after 4-5 days, the clinical picture begins to subside and a recession begins.

Severe form

The period of precursors has pronounced symptoms of a violation of the general condition: headaches, chills, weakness, loss of appetite, fever above 38 ° C, intoxication phenomena. The inflammatory process involves not only the area to which the parotid glands are located, but the entire neck. In some cases, the swelling can reach the collarbones.

The parotid gland is very enlarged, painful on palpation. It strongly pushes the earlobe up and forward, due to which the external auditory meatus narrows. Swallowing and opening the mouth becomes difficult and painful.

With the involvement of the other major salivary glands, the swelling greatly increases the size of the neck. Against the background of these changes, phenomena often join. The salivary duct of the parotid gland is well palpated in the form of a large cord. The separation of saliva in the oral cavity is significantly reduced or completely stops.

With the development of purulent-necrotic processes in the lobules of the gland, pus can be released from the duct, and there is a high probability of developing an abscess. Severe parotitis very often leads to serious complications. The most formidable of them are:

meningitis;
encephalitis;
damage to the cranial and spinal nerves;
damage to the auditory nerve;
various mental disorders;
infertility;
orchitis;
mastitis;
damage to the renal apparatus.

Most often epidparotitis ends with complete recovery, however, with insufficient or inadequate therapy, there may be fatal cases. In addition, inflammation of the salivary glands may be due to influenza infection - the parotid gland is more often affected, but other salivary glands can also be involved in the process. Very often the process is bilateral, sometimes the parotid and submandibular gland can be affected only on one side. In addition to the main clinical picture, there may be pain when moving the tongue, as well as an increase in the number of sublingual folds.

Postoperative and postinfectious sialadenitis most often affects the parotid glands. It can develop in any severe disease due to hematogenous or lymphogenous transfer. The cause of the development of inflammation in the gland, as a rule, are bacteria, E. coli. This form of the disease is dangerous because, in its extreme manifestation, it can lead to the development of necrosis of the salivary gland or an abscess of the pharyngeal space. Also, occasionally, purulent fusion of the walls of blood vessels occurs and bleeding develops.

The presence of a foreign body that has penetrated into the ducts of the salivary glands can lead to inflammation. May disturb the periodic increase in the salivary gland, a decrease in the separation of saliva. Gradually, the signs of inflammation subside and may not appear for a long time, then they appear again. Such a periodic course can last until a complete picture of acute sialadenitis develops with purulent-inflammatory phenomena in the lobules of the gland. The inflammatory process often moves to nearby soft tissues, to other parotid glands. Often there is a spontaneous removal of the interfering foreign body. However, most often, to eliminate the cause of the disease, one has to resort to surgical methods.

General principles for the treatment of inflammation of the salivary glands

In uncomplicated cases with mild and moderate forms, treatment is usually symptomatic and is aimed at preventing the development of complications. As mandatory measures, it is necessary to include daily wet cleaning of the premises with disinfectant solutions, airing.

The proverb “Cleanliness is the key to health” is especially relevant for diseases of the salivary glands.

It is recommended to rinse the mouth with soda solutions, citric acid, which helps to increase salivation and flush out stagnant contents from the salivary glands. Peppermint also enhances salivation. The diet should include foods that increase saliva production.

bed rest for a period of elevated temperature, especially this item applies to adult patients;
it is necessary to apply warming saline or alcohol compresses, ointment dressings to the area of the inflamed gland;
warming physiotherapeutic procedures are also shown: UHF, solux;
it is recommended to rinse the mouth and irrigate with various antiseptics - Furacilin, eucalyptus, Chlorophyllipt, Chlorhexidine.

In severe complicated forms of sialadenitis, antibiotic therapy is necessary. Its goal is to eliminate inflammation and restore the normal functioning of the gland. Through the duct, 50 thousand units of benzylpenicillin and 100 thousand units of streptomycin with 0.5% procaine are injected into the salivary gland. Besides:

for analgesia, relieving inflammation and improving microcirculation, compresses with Dimexide are prescribed;
physiotherapeutic procedures are also needed: warming compresses, heating pads, UHF;
if the symptoms do not subside, prescribe intramuscular injections of antibiotics, sulfa drugs and hyposensitizing agents;
sometimes they resort to active drainage of the salivary glands, which allows you to pump out stagnant contents and relieve signs of inflammation.

With a necrotic course of the process, surgical intervention is indicated to open the capsule of the affected salivary gland and eliminate destructive processes. The prognosis of the disease is generally favorable.
//www.youtube.com/watch?v=UZ2mJGi753c

Sialadenitis is a dangerous pathology that provokes the development of severe complications. Behind the medical term is inflammation of the salivary glands. Many believe that the disease develops with hypothermia or a cold. Unfortunately, there are enough provoking factors.

Sialadenitis is especially dangerous for men: one of the forms of pathology affects important glands. Information about the nature, symptoms, methods of treatment of the inflammatory process will certainly be useful to people of different ages and gender.

general information

"The salivary glands play an important role in the functioning of the body." This stamp reflects the real meaning of small formations. Any changes in the composition of saliva, the volume of fluid produced affect the general condition.

The production of the enzyme lysozyme supports strong immunity. The parotid glands affect protein and mineral metabolism, producing parotin, a hormone-like substance.

With inflammation of the parotid salivary glands, the infection quickly spreads throughout the body with blood, lymph, through carious cavities. Important glands are attacked by pathogens in the same way. The consequences of sialadenitis are sometimes very severe: from damage to the auditory nerve to pathologies of the renal apparatus.

Take note:

the largest salivary gland is the parotid. The formation is located in front of the auricle and slightly lower. This area is the most inflamed. The disease is called parotitis;
the sublingual gland is symmetrically located at the bottom of the oral cavity;
the submandibular gland is located near the molars, at the end of the dental arch, under the lower jaw.

All types of salivary glands are paired.

Causes of sialadenitis

The inflammatory process is caused by several factors:

bacterial or viral infection. The causative agent enters the body by airborne droplets, penetrates the glands, provokes inflammation. There is swelling, soreness. Most often, doctors identify a mixed flora of pneumococci, streptococci and staphylococci. Sometimes the course of sialadenitis is complicated by the addition of a fungal infection;
inattention to the hygiene of teeth and gums. Oral problems often begin with a buildup of deposits colonized by decay bacteria. The infection quickly spreads to new areas, sometimes penetrating into the glands that produce saliva. Without attention to oral hygiene, it is difficult to eliminate the pathological process, to prevent relapses;
sialolithiasis or the formation of stones in the ducts. Rarely enough, the channel blocks the formation that disrupts the outflow of saliva. Sometimes the ducts are clogged when tissues are injured with a coarse brush, sharp edges of food, or a foreign body enters;
inflammatory process, as a complication of serious diseases (typhoid, tuberculosis, encephalitis, pneumonia). Sometimes the glands become inflamed after surgical treatment, colds, viral infections.

Symptoms

Characteristic signs:

decreased saliva volume, dry mouth, discomfort, burning sensation;
pain when swallowing, chewing food. With severe inflammation, it is difficult for the patient to even open his mouth wide;
in the area of the affected gland, a seal is palpated;
there is redness of the inflamed area;
a putrid odor from the oral cavity appears, an extraneous taste is felt;
when pressing on the painful area, pain is felt: purulent masses accumulate inside;
shooting pain appears in the infection zone, often radiating to the oral cavity or ear;
weakness is often felt, the temperature rises to 39 degrees, a feverish state develops.

Diagnostics

Which doctor should I contact for inflammation of the salivary glands? Visit a dentist or therapist. During visual inspection, palpation easily detects an inflamed area.

Based on the results of the examination, a diagnosis of sialadenitis is made. If extensive inflammation is suspected, ultrasound or computed tomography is mandatory.

Methods and rules of treatment

The doctor chooses the method of therapy depending on the severity of the disease, the causes of sialadenitis. With the development of complications, a long-term temperature of 39-40 degrees does not require hospitalization.

Important! If the cause of inflammation is diseases of the mouth, nasopharynx, colds, the first phase of treatment is aimed at combating pathological processes. With angina, SARS, acute respiratory infections, tonsillitis, diphtheria, sanitation of the oral cavity and ear ducts is mandatory. After the cause is eliminated, the patient recovers as soon as possible, if complications do not develop.

The main methods of treatment:

physiotherapy procedures: solux, UHF;
heating the inflamed area with alcohol or saline compresses;
rinsing the mouth with antiseptic solutions. Furacilin, Chlorhexidine, Chlorophyllipt have a detrimental effect on bacteria;
compresses with Dimexide - a good option for relieving pain, improving microcirculation in the affected area;
antibiotic therapy. An antibiotic susceptibility test is mandatory. Often, the analysis shows the presence of several types of pathogens. Self-administration of drugs is strictly prohibited;
when detecting fungi, viruses, antimycotic, antiviral drugs are effective. Antihistamines will help relieve manifestations of allergic reactions;
if the symptoms do not disappear, after a few days the doctor prescribes intramuscular injections of hyposensitizing and sulfa drugs. In severe cases, antibiotics are administered in the same way;
a solution of streptomycin with procaine 0.5% and benzylpenicillin showed high efficiency;
active drainage of the salivary glands with an abundance of purulent masses. Timely removal of exudate reduces inflammation, prevents the development of infection.

Mandatory treatment items:

bed rest;
wet cleaning twice a day;
refusal of coarse food that injures the inflamed area;
the use of liquid and puree-like products that do not irritate the affected area;
food that provokes increased salivation, for the speedy removal of toxins from the affected areas;
food and drinks should be warm. Both hot and too cold dishes are not recommended.

Therapeutic rinses

In addition to pharmacy antiseptic solutions, use folk recipes. Herbal decoctions, solutions based on useful components increase the production of saliva, accelerate the washing out of purulent masses from the salivary glands.

Use:

mint decoction (increases salivation, refreshes the oral cavity, reduces soreness);
chamomile decoction (anti-inflammatory, decongestant);
citric acid (increases the volume of saliva);
a decoction of raspberry leaves (has an active anti-inflammatory, wound healing effect);
soda solution (reduces inflammation, reduces swelling, disinfects, softens the affected tissues).

Possible Complications

The danger of the inflammatory process in the salivary glands is the spread of infection throughout the body. If left untreated, the consequences can be the most severe.

Of particular danger is mumps or, in the popular way, "mumps". Complication develops with damage to the parotid gland.

With an unfavorable development of events, not only the salivary, but also the sex glands are affected. In severe cases, even infertility is possible. Sometimes there are problems with the pancreas.

Other complications:

disorders of the nervous system, meningitis;
necrotic changes in the salivary gland;
the formation of fistulas through which pus appears on the surface;
the occurrence of numerous abscesses on the affected tissues and next to them;
life-threatening purulent formations: phlegmon in the oral cavity, abscess, blood poisoning;
an increase in the abscess, a breakthrough of exudate into the oral cavity, the active spread of infectious agents.

Running cases of the inflammatory process sometimes provoke:

mastitis;
orchitis;
infertility;
encephalitis;
damage to the spinal and cranial nerves.

There are no specific measures to prevent inflammatory processes in the salivary glands. A set of measures is aimed at maintaining the health of oral tissues.

Remember the basic rules:

thorough hygiene of the gums, dentition, cleansing of the tongue;
refusal to use crackers, chips, lollipops that cause irritation, microtrauma of the mucosa;
strengthening immunity, preventing colds;
in winter, in spring, take multivitamins, immunomodulators to maintain the body's defenses;
refusal of self-treatment with symptoms of pathological processes in the oral cavity.

Sialadenitis is dangerous with complications. In case of soreness, redness, induration in the area of the salivary glands, visit a dentist or therapist as soon as possible. The specialist will determine the cause of the inflammatory process, prescribe an examination.

Timely treatment of inflammation of the salivary glands will prevent the spread of purulent discharge over large areas. Remember: many complications of sialadenitis are life-threatening!

Learn more interesting information about the disease from the following video:

Salivary glands in humans are not so small. Two parotid (one at each ear), two submandibular (on each side under the lower edge of the jaw) and two sublingual. In addition, there are many different small glands in the sky, cheeks, tongue, lips, mucous and submucosal of the mouth.

And each of these salivary glands one far from perfect day can become inflamed, bringing a lot of trouble to its owner. This condition will be called sialadenitis. A special case of inflammation of the parotid salivary gland is called parotitis. We will talk about inflammation of the salivary glands, symptoms and treatment of sialadenitis further.

Why do they get inflamed

The culprits of inflammatory changes are most often:

When an infectious agent enters the salivary gland, the mucosa swells, the duct that excretes saliva narrows, a clear or purulent fluid accumulates in it, and salivation becomes difficult. With the continued existence of such a situation, the gland gradually atrophies or scars, ceasing to produce and secrete a sufficient amount of saliva.

The infection most often penetrates through the mouth of the duct, less often with the flow of blood, lymph:

against the background of respiratory infections of the pharynx, trachea, periodontitis, skin boils
or by contact from nearby areas (with purulent diffuse inflammation of soft tissues).

Main reasons:

The causes of inflammation of the salivary glands in 30% of cases are mumps viruses (or mumps).
In addition to the infectious process, gland damage can be included in the program of rheumatic diseases (Sjögren's syndrome)
and radiation damage.
Up to 40% of all inflammations are due to dentistry.

Acute sialadenitis is often infectious.

Chronic inflammation involves the gland tissue itself (parenchymal), its connective capsule (interstitial) or duct in the process. In this case, the disease lasts more than 3 months with periods of peak and remission of inflammation.

What can be seen

The acute process is characterized by the following manifestations:

Edema appears at the location of the inflamed gland,
It is painful and tight when pressed.
If you massage the gland, pus may be released from its duct.
The mouth dries out due to a small amount of saliva, or vice versa, saliva flows all the time.
The temperature may rise.

The pain that the patient feels is located in the projection of the affected gland, can be given to the ear, neck, lower jaw, oral cavity (damage to the submandibular salivary glands). They are oppressive, bursting in nature.

Factors contributing to sialadenitis:

dehydration,
high calcium content in the blood (stones of the ducts of the glands can form, clogging them).

The chronic form of the disease often leads to scarring and atrophy of the glandular tissue, due to which the production of saliva drops significantly, swallowing and speech become difficult.

Interstitial sialadenitis is characterized by painless swelling of the gland. They are more likely to affect people over 40 with immunity errors (diabetes mellitus, hypothyroidism). At the beginning of the process (the process is often symmetrical), the glands are densely elastic, then they become denser. Dry mouth may appear, a drop in efficiency. In exacerbation, pain appears, aggravated by cold.
The parenchymal variant is more often congenital. There is also periodic swelling, salivation with an admixture of pus, with a gradual drop in the level of saliva production.
The ductal variant develops both against the background of a wider congenital duct, and as a result of its acquired expansion (in trumpeters, glassblowers), usually in old age. Do not discount the foreign bodies in the duct, which often give symptoms of inflammation of the submandibular salivary gland. Usually the disease begins suddenly with bursting pain and its increase, more often after eating. When pressed, a secret is released. When the bacterial flora is attached, the temperature rises, swelling increases, and pus is released.

The most formidable complication of such a pathology is abscess formation (the formation of a limited abscess at the site of the gland) and sepsis.

Piggy

Under this spiritual name, acute inflammation of the parotid salivary gland (mumps) occurs. The disease is caused by a virus transmitted by airborne droplets from a person, which is contagious up to the ninth day from the onset of the disease. Children and unvaccinated adults are more likely to get sick. Since the virus has an affinity for glandular tissue, other salivary glands can also be affected, as well as the pancreas and testicles in men or boys, and the ovaries in women.

The virus does not tolerate the environment well, is sensitive to antiseptics and ultraviolet radiation, but tolerates low temperatures and freezing. After the introduction of its RNA into the cells of an infected person, about 18 days pass before the development of the clinic.

Symptoms of unilateral inflammation of the salivary gland: swelling, pain near the ear, salivation, muscle and headaches, fever.

Diagnostic search

With complaints to children, a pediatrician is called, adults themselves come to a therapist, an infectious disease specialist, a dentist, less often a surgeon or a venereologist.

The diagnosis is suspected on the basis of complaints, examination, palpation of the gland.

Ultrasound and radiography are methods for visualizing the glands.
To clarify the nature of inflammation, serological blood tests are performed (if a viral infection is suspected): looking for immunoglobulins to virus antigens. For example, with parotitis, during the incubation period, immunoglobulins may not yet be present or their titer is low (repeat the analysis after a couple of days). From the moment the symptoms appear, there are immunoglobulins M in the blood, with an advanced disease - M and G. After its resolution - G (they also provide immunity after the illness).
For bacterial and viral infections, the polymerase chain reaction (for blood or secreted glands) remains a universal diagnostic method with maximum sensitivity. It can also be used as an express diagnostic.
Bacterial agents make it possible to perform a more complex and time-consuming culture of the separated gland with the growth of bacterial colonies and the determination of their sensitivity to antibiotics.
A biopsy may be required in cases of suspicion of an autoimmune process or for differential diagnosis.

How to treat

The patient is placed in protective mode. Treatment of inflammation of the salivary glands at the initial stage is outpatient. Shown milk-vegetarian diet, drinking plenty of water, rinsing the mouth with acidified (lemon juice) solutions or Kaposol.

Local treatment options:
- With mumps - warming alcohol compresses on the parotid region, a blue lamp (sollux), in a polyclinic - UHF, electrophoresis.
- In case of inflammation of the glands of the oral cavity - rinsing with antiseptics (Miramistin, Furacillin solution: 2 tablets per glass of water), baking soda solutions: a teaspoon per glass of water.
Antiviral drugs are used more often for mumps, but their effectiveness is poorly proven today.
If antibiotics are being treated, which antibiotics should be used? The choice is based on the high resistance of the oral flora to antibiotics. The first-line drugs are Amoxicillin (Ospamox, Amosin) and Amoxicillin clavulanate (Amoxiclav, Flemoclav, Augmentin), the second is Cefixime (Zinnat, Suprax) or Josamycin (Vilprafen).
Paracetamol, Ibuprofen (up to three times a day) can be used to reduce pain, intoxication and fever.
A chronic process in the acute stage requires antimicrobial therapy, anesthesia. In the stage of remission - resolving therapy or replacement of saliva deficiency (rinsing with Kaposol). The same tactics are followed for Sjögren's syndrome and radiation damage to the glands.
The surgical stage may be required for suppuration of the glands, duct stones. Stones can be removed during duct bougienage, lithotripsy, lithoextraction.

Prevention

For mumps - vaccinations in childhood, non-specific quarantine measures in children's groups during epidemics, sanitization of premises, personal protective measures for healthy adults caring for the sick (masks, hand washing).

It is also worth paying attention to the state of the immune response (eat well, correct hormonal pathologies, do not take uncontrolled drugs that reduce immunity, beware of radiation).

Paradoxically, barrier contraceptive measures (condoms, latex wipes) protect against specific inflammation of the salivary glands against the background of genital infections.

Timely and preventive visits to the dentist, adequate care of the teeth and oral cavity prevents the development of odentogenic sialadenitis.

Symptoms of sialadenitis

Inflammations in the area of all salivary glands have a similar clinical picture:

The process of secreting the required amount of saliva is disrupted.
There may be a "shooting" pain in the focus of infection, giving into the oral cavity, neck or ear.
There is noticeable discomfort not only during chewing and swallowing, but even when trying to minimally open your mouth.
There is a slight swelling with redness on the skin in that part of the face where the salivary glands are located on the inside.
The formation of pus is evidenced by the appearance in the mouth of an unpleasant taste and smell, as well as a noticeable feeling of pressure and "bursting".
In the area of \u200b\u200bthe inflammatory process, you can feel a painful seal with your hand.
The temperature often rises to 39 ° C and above.
Feeling of weakness, chills and other signs of intoxication.

Causes of sialadenitis

The disease can be both primary (develops as a result of the formation of a viral infection in the mouth), and secondary, which occurs after other inflammatory processes have been transferred. In the second case, fungi and bacteria serve as the causative agent.

Pathogenic microorganisms penetrate through the ducts of the glands, with the lymph flow, the bloodstream and by contact in such diseases:

Acute tonsillitis and chronic tonsillitis.
Complex caries.
Stomatitis affecting the mucous membrane of the gums and oral cavity.
Scarlet fever, measles and other infections.
Chronic diseases of the nasopharynx - adenoiditis, various forms of rhinitis, sinusitis.
Poisoning with salts of heavy metals.
Orchitis, salivary stone disease and mumps.

Lymphogenic sialoadenitis is a direct consequence of immunodeficiency, which is expressed in the form of swelling, gradually turning into phlegmon or a dense abscess. Contact sialadenitis occurs as a result of rupture of abscesses in the region of the salivary glands, after which purulent discharge appears in the saliva.

In turn, salivary stone disease provokes swelling mainly during meals, but the formed stones often have to be removed using surgical methods.

Sometimes sialadenitis develops in people suffering from cancer. In such cases, inflammatory processes occur against the background of a general decrease in immunity. Similar risk factors include prolonged fasting and dehydration.

To newborns, pathogens of sialadenitis enter through the placenta from the mother.

Diagnostics

Usually this disease is diagnosed already during the initial examination, but if there is a suspicion of the development of abscesses or abscesses, the doctor may prescribe an additional examination. In such cases, it is necessary to undergo an ultrasound or CT scan. MRI is considered the most effective diagnostic method in this case.

Methods for the treatment of inflammation of the sublingual salivary gland

The choice of methods of therapy for sialoadenitis depends entirely on how quickly the patient reacted to the appearance of pain and unusual dryness in the oral cavity:

At the first stage, it is enough to use solutions of stomatofit, furatsilin, ordinary soda or manganese for rinsing. If time is not lost, the inflammation will quickly pass.
The appearance of a high temperature indicates progress in the development of the disease, so if necessary, you need to take antipyretics such as paracetamol or ibuprofen and seek help from a specialist. In the case when pus is released when pressing on the painful area, it is unlikely that the problem will be solved without consulting a surgeon. He will open the abscess and install a drain.
With inflammation of the salivary glands, UV irradiation, electrophoresis, UHF, solux and other physiotherapy are often prescribed. It is also advisable to consume more sour and salty foods for a short time in order to provoke the process of salivation. A certain effect is brought by chewing gum and a small slice of lemon before dinner, which should simply be held in the mouth for a short time. Pieces of solid honey can be used in a similar way. For the same purpose, it is useful to chew crackers, cranberries, sauerkraut. These products help remove dead cells from the area of inflammation, which contributes to faster tissue regeneration.
In some cases, when the inflammation is accompanied by high fever and causes severe pain, the patient may be prescribed antibiotics. To relieve severe pain, non-steroidal anti-inflammatory drugs are used - Pentalgin, Baralgin, Ibuprofen.
To reduce the overall level of intoxication, it is recommended to drink plenty of fluids. It can be not only water, but also fruit drinks, juices, decoction of wild rose and other medicinal plants, tea.

Folk remedies

Home remedies are used in the treatment of inflammatory processes in the salivary glands are also quite common. Time-tested recipes are prepared from a wide variety of natural ingredients:

Compresses

Celandine grass (3 tablespoons) is poured with boiling water (300 ml), put on fire, brought to a boil and insisted for 3 hours. A cotton cloth or gauze soaked in the product should be applied to the edema up to 4 times during the day.
Celandine root (300 g), fresh flowers of St. John's wort and yarrow (50 g each) are passed through a meat grinder, poured with vodka (0.7 l) and infused for 7 days in a darkened room.

Ointments

Pork fat (100 g) must be mixed with camphor powder (20 g), lubricate the swelling with it, cover with a napkin and hold for about 3 hours.
A mixture prepared from petroleum jelly and birch tar (proportion 1:10) lubricates the puffiness in the region of the salivary glands.

The salivary glands produce saliva, which is directly involved in the process of digestion. Inflammation of the submandibular salivary gland may occur due to infection.

Read more about how to choose a toothpaste for sensitive teeth here.

Means for dealing with hypersensitivity of the teeth are presented in this review.

Internal funds

Alcohol (50 ml) must be added to a container with crushed propolis (20 g) and shaken thoroughly for half an hour.

The medicine is infused for about a week, after which it is filtered through cheesecloth and taken according to the following scheme: the first day - 20 drops, and then 40 drops in three doses, dissolving the agent in milk or plain boiled water. Course - 3 months.

Prevention

To prevent the development of inflammatory processes in the area of the salivary glands, it is necessary, first of all, to strictly observe the rules of oral hygiene. Doctors recommend paying special attention to the health of the gums and teeth, because caries, periodontitis and other dental diseases are often the root cause of the development of sialadenitis.

It is also important not to ignore viral infections and acute respiratory infections, because even, at first glance, a mild cold can lead to such undesirable complications as inflammation of the sublingual gland.

When caring for the oral cavity, it is necessary to pay attention not only to the teeth, but also to the tongue, gums, tonsils, which can serve as a focus for the development of infections.

Stagnation in the sublingual salivary glands can also be avoided if they are regularly massaged at the exit points with the tongue. Massage of the gums is also useful, which prevents the development of many infectious diseases that contribute to the development of sialadenitis.

At the slightest sign of a violation of the process of salivation, you should immediately begin to irrigate your mouth with a solution of ordinary citric acid. This simple procedure will help clear the salivary ducts quickly and naturally. A decoction of chamomile, plantain and calendula helps well. To prepare the product 1 tsp. herbal mixture should be poured with a glass of boiling water.

Rinsing is carried out the maximum number of times during the day.

It is possible to detect the disease in a timely manner with the help of a daily examination of the state of the oral cavity.

The advanced stage of sialadenitis often becomes chronic, which requires long-term treatment.

Dentists are familiar with such a problem as a cyst of the parotid salivary gland. The disease causes severe discomfort, but is treatable.

Did you know that stones can form in the salivary glands? Read about the causes of salivary stone disease here.

Inflammation of the sublingual glands is most often caused by the penetration of bacteria and viruses into them, and also as a result of blockage of the salivary ducts. In such cases, it is very important to consult a doctor in a timely manner.

Without an accurate diagnosis and professional treatment, the disease becomes acute, which often requires surgical intervention.

The reasons

Photo 1. Location of the parotid salivary gland

Poor oral hygiene
Reactive obturation, when obstruction of the abdominal organs is observed, for example, as a result of surgery, the development of a malignant tumor, diseases of the gastrointestinal tract, stress, malnutrition, or exposure to diabetes mellitus. As a result of obstruction, the ducts narrow reflexively, due to which the volume of saliva secreted decreases and it accumulates at the place of production. All this creates a favorable environment for microorganisms from the oral cavity to take root and begin to multiply in the parotid gland.
Mechanical obturation, when the duct is blocked by a foreign object, such as a calculus. The result here is the same as with reactive blockage - the development of inflammation.

genetic features
Autoimmune abnormalities
Situations of high stress
hypothermia
Getting injured
Weakness of the body against the background of a serious illness

In older adults, chronic inflammation is more common than in children and young adults. This is due to atherosclerotic phenomena, due to which the blood supply and nutrition of the salivary gland deteriorates. Atherosclerosis occurs as a result of the aging of the body, when the vessels and arteries slowly wear out and lose their tone.

Symptoms and photos

Photo 2. Inflamed salivary glands in the mouth

With the development of the disease or if there is no adequate treatment, the disease also moves to the salivary glands under the tongue and lower jaw.

The presence of additional symptoms will depend on the type of inflammatory process, and if the disease is not treated, then it goes through several stages in turn:

Serous
Purulent
Gangrenous

Photo 3. External symptoms of inflammation

A sharp stabbing sensation of pain that increases when taking food
Impaired salivation
Dryness in the mouth
Swelling and tuberosity in the submandibular area
Purulent discharge from under the tongue
An increase in the volume of the salivary gland during periods of eating, which is expressed by discomfort, and sometimes even does not allow you to eat normally

The sublingual salivary gland becomes inflamed in rare cases, most often it occurs against the background of an abscess or lesions of the teeth.

Chronic sialadenitis

Chronic disease takes many forms.

A sharp increase in symptoms happens suddenly, its first sign is a dry mouth. At the same time, the gland itself acquires an increased size, becomes painful and smooth to the touch. After the exacerbation has passed, the size of the organ does not return to normal, remaining several times larger.

Diagnostics

Treatment of inflammation of the salivary gland

How to treat acute sialadenitis

At mumps treatment is prescribed based on the symptoms present. Interferon agents are mainly used, and the patient is also shown to be treated with antipyretic and analgesic drugs.

The use of a salivary diet to train the muscular structure of the ducts through which saliva is excreted. Diet products include everything sour, such as lemon, cranberries, and crackers.
The introduction of antibiotics and antiseptics into the cavity of the duct, for example, penicillin and gentamicin, dioxidine and potassium furaginate.
The use of an anti-inflammatory compress based on a Dimexide solution, which anesthetizes and suppresses the progression of the disease.
Physiotherapy using UHF and warming.
Blockades based on novocaine and penicillin with severe edema and a sharp increase in inflammation.
Taking systemic antibiotics. Which antibiotics to choose the doctor decides after studying the bacterial environment.
Intravenous injections.

Surgery as a treatment is used in the purulent course of the disease. The gangrenous course is the most severe, it requires an urgent operation under general anesthesia. If the cause of the pathology is a calculus, then it must be removed, otherwise relapses will be repeated again.

How is a chronic condition treated?

In exacerbations, treatment is the same as in the acute form. In periods when there is no exacerbation, the chronic form is treated:

Massages of the ducts, when an antibiotic is additionally introduced into their cavity to combat purulent phenomena
Novocaine blockades, electrophoresis, which increase secretion
Daily galvanization course
The introduction of solutions that prevent the development of exacerbations
X-ray therapy, due to which the inflammation of the salivary gland is well stopped
Removal of the gland, the restoration of the functionality of which is impossible.

Which doctor treats

Preventive measures

Standard non-curative prophylaxis includes:

Compliance with oral hygiene
Timely cleansing of infectious foci in the mouth, often associated with caries and other dental lesions
Tracking congestion in salivation and preventing them by taking special medications (pilocarpine), rinsing with furacilin, rivanol and other antiseptics.

The salivary glands play an important role in the digestive process. When chewing, food is moistened with saliva produced by the glands. In addition, saliva prevents the penetration of bacteria and viruses, thanks to which the oral mucosa does not dry out.

In the oral cavity there are small large paired salivary glands - sublingual, submandibular, parotid. If inflammation of the salivary gland, otherwise called sialadenitis, appears, the amount and composition of the secreted saliva changes, digestion is disturbed, and the protection of the oral cavity decreases.

Causes of inflammation

Penetrating into the salivary glands, bacteria and viruses cause an inflammatory process. This can happen against the background of viral infections, for example, during the flu or pneumonia.

If the parotid salivary glands are affected by viruses, mumps or mumps develops. The disease is common, especially in children. If it appears in adults, then the treatment becomes more complicated.

Inflammation can be caused by:

pneumococci,
streptococci,
staphylococci.

They are activated against the background of general weakness of the body, reduced immunity.

The inflammatory process can begin after surgery. Anesthesia, administered before the operation, acts depressingly on the work of the salivary glands. If you take care of oral hygiene in time, you can avoid bacterial inflammation.

Often, diseases of the salivary glands manifest themselves in oncology due to reduced immunity. The infection can penetrate into the salivary ducts with inflammation of the lymph nodes, gums, stomatitis, diseased teeth.

There are cases of inflammation in newborns. The reason for this is the cytomegalovirus, which passes through the placenta during pregnancy and infects the fetus.

Symptoms of the disease

Inflammation of the salivary glands is accompanied by unpleasant symptoms:

the glands are enlarged
harden,
hyperemia may occur
there are pains in the mouth and in the neck.

If the parotid glands are inflamed, then pain in the ear, temple, and head may be felt. Similar symptoms are observed with otitis media, which complicates the diagnosis at an early stage.

There is constant pressure on the inflamed area of the salivary gland. This indicates the accumulation of purulent infiltrate.

Forms of the disease

Acute sialadenitis is of two types: viral and bacterial - depending on what is the causative agent of the disease.

One of the varieties of a viral disease is influenza sialadenitis. Usually appears during or after the flu. There is discomfort in the affected area, acute pain, general weakness, fever. In addition, there is swelling in the area of the gland, the outflow of saliva decreases. The acute period lasts about 7 days, then the symptoms disappear, but the infiltrate remains, which resolves slowly. In this case, a seal is formed, salivation may stop. Proper treatment, even at this stage of the development of the disease, can restore the activity of the salivary gland.

Especially severe forms of influenza sialadenitis are rare. Severe pain occurs, body temperature rises. Purulent fusion and necrosis may occur. The disease, starting in one gland, can go to the steam room. The structure of the gland changes in just a couple of days. After purulent fusion, necrosis begins. Requires surgery.

Influenza sialadenitis develops in most cases in the parotid gland, rarely in the submandibular. In 50% of cases, inflammation of the salivary gland extends to the steam room. Treatment consists in irrigation of the oral cavity with interferon. If there are signs of secondary infection, antibiotics are introduced into the gland. Small salivary glands become inflamed extremely rarely.

With beriberi, impaired water-salt metabolism, violation of the properties of the secretion of the salivary gland, salivary stone disease can develop. Salivary stones form in the sublingual glands. Contribute to their development salivary blood clots or foreign bodies in the duct. Increasing in size, the stone clogs the duct. This is accompanied by severe pain and accumulation of pus. Duct massage, heat compresses, or stone removal are prescribed.

Treatment

If symptoms appear that indicate the onset of inflammation of the salivary glands, you should consult a dentist. With timely treatment, treatment passes quickly.

If pus appears when pressing on the affected area, then a surgeon will be required. In such a situation, the inflamed area is opened, pus is removed and drainage is placed.

If there is an acute form of the disease of the salivary glands, then inpatient treatment is prescribed. Symptoms of a mild form of inflammation are relieved by rinsing the mouth with a solution of soda, furacilin or potassium permanganate. To reduce fever, antipyretic drugs are prescribed.

Physiotherapy helps:

electrophoresis,
sollux.

If the inflammation is accompanied by symptoms characteristic of the acute form of the disease - fever, significant abscess, etc. - a course of antibiotics is prescribed. A constant outflow of saliva is required, which contributes to the removal of the bacteria that caused the disease. To do this, it is recommended to include in the diet:

citrus,
sour, salty foods
chewing gum is good.

If inflammation occurs frequently, taking on a chronic form, then antibiotics are injected directly into the salivary gland.

Surgical intervention is required if therapeutic treatment has not worked. Then the iron is removed completely or part of it.

Inflammation of the salivary glands in children

In children, most often, especially during the cold period, epidemic parotitis develops. It is transmitted by airborne droplets, but can also spread through objects. The disease manifests itself in the gland on day 3, and after 7 days, antibodies to this infection are produced in the child's body.

With a mild form of mumps - there is a slight swelling, mild pain, the temperature does not rise. Within a week, the symptoms disappear.

In the middle form, common symptoms appear at the beginning of the disease:

weakness,
chills,
muscle and headache
the child's appetite decreases
the temperature rises.
edema appears
impaired salivation,
it becomes difficult to chew food,
thirst appears.

Improvement occurs in 3-4 days.

In severe cases, both glands are affected. Inflammation from the parotid glands can go to the submandibular glands, which causes the neck to swell, and there are difficulties with swallowing. The development of the disease leads to the release of pus. The child's temperature may rise to 40°C. This form of mumps is dangerous with complications, meningitis, encephalitis, and optic nerve paralysis may develop. The disease is curable, but if the brain and central nervous system are affected, then the prognosis is unfavorable, a fatal outcome is possible.

For preventive purposes, it is necessary to control the condition of the oral cavity, preventing the occurrence of inflammatory processes, and to treat gum disease and caries in a timely manner. Otherwise, the disease can become chronic.