Acute bacterial sialadenitis: a study of 29 cases and review

Acute bacterial parotitis (ABP) used to be described as a nosocomial postoperative infection associated with a high mortality. A review of the literature on acute bacterial sialadenitis (ABS) revealed Staphylococcus aureus as the most common pathogen. Between 1970 and 1988, 17 patients with ABP and 12 with acute bacterial submandibular sialadenitis (ABSS) were admitted to a university hospital. Cultures of purulent discharge from the salivary ducts of these patients revealed S. aureus in 53% and viridans streptococci in 31%. During the study period, only six nosocomial cases of ABP occurred out of 289,234 admissions. S. aureus was the organism isolated most frequently in the nosocomial cases. There were no deaths, and all patients recovered following antibiotic treatment without surgical drainage. Advances in antimicrobial therapy and fluid management of hospitalized patients have made nosocomial ABS a rare disease with a favorable prognosis. S. aureus remains the most common pathogen causing ABS even in nosocomially infected patients who are not critically ill.