Sialadenitis - acute or recurrent

The Department will periodically contact patients waiting for an outpatient clinic appointment via SMS, with a link to an electronic form.  This is part of routine waitlist auditing to ensure patient details are up to date.  If you receive this SMS, please update your details.

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).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

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