'Simsalyeom' ... Fever and chills, not a cold or flu?

Office worker A recently experienced fever and chills along with a sudden loss of appetite, thinking it was just a cold. Due to the sudden cold weather and large temperature differences, the number of people with colds around him increased, and A also thought it was a mild cold and did not pay much attention to it.

Usually, A would purchase over-the-counter medicine from a pharmacy for mild colds and expected the symptoms to improve within a week. However, as time passed, the fever and chills worsened, and pain in the jaw area intensified, making it difficult to open the mouth or chew food. Suspecting another illness, A was diagnosed with sialadenitis at a nearby otolaryngology clinic and is currently undergoing treatment.

Salivary gland inflammation. [Image source=Clipart Korea]

Saliva is a digestive fluid secreted by the salivary glands. On average, about 0.75 to 1.5 liters are secreted daily, softening food to make it easier to swallow.

In addition to keeping the oral cavity moist, saliva plays a role in immune defense against pathogens. It is mostly composed of water, with about 0.5% consisting of digestive fluids, electrolytes, mucus, glycoproteins, and enzymes.

This saliva is secreted from the major salivary glands?the sublingual gland (under the tongue), parotid gland (near the ear), and submandibular gland (under the jaw)?as well as from numerous small salivary glands in the mouth and pharyngeal walls. Approximately 800 to 1000 small salivary glands are distributed throughout the oral cavity, including the palate, cheeks, and gums. Inflammation occurring in any of these numerous salivary glands due to various causes is called sialadenitis.

Sialadenitis mainly occurs due to viral or bacterial infections such as mumps (epidemic parotitis). It can also develop when saliva flow is blocked or reduced due to immunosuppression, chronic diseases, facial radiation therapy, old age, dehydration, trauma, or side effects of medications. Additionally, sialolithiasis, where calcified stones form in the salivary glands or ducts, blocking the flow, can also cause sialadenitis.

Symptoms include pain, heat, and swelling at the affected site, with pain worsening when chewing or opening the mouth. Inflammation can reduce saliva secretion, causing dry mouth. In severe infections, pus may form in the salivary glands.

Dr. Youngjin Noh, head of the Ear, Nose, and Throat Center at Daedong Hospital and an otolaryngology specialist, said, “When sialadenitis occurs acutely, symptoms similar to cold or flu, such as fever and chills, may appear. If jaw or ear pain accompanies cold or flu symptoms, or if the symptoms differ from usual colds or flu, it is important to visit a nearby hospital for an accurate diagnosis and appropriate treatment.”

Daedong Hospital Ear, Nose, and Throat Center, Chief Physician Youngjin No (Otorhinolaryngology Specialist).

Treatment for sialadenitis depends on the cause and includes medication such as antibiotics, along with oral hygiene management and lifestyle modifications like adequate hydration. Symptoms can improve within weeks with treatment, but if there is no response to medication or if differentiation of the inflammation state is needed, imaging tests such as computed tomography (CT) can be used to check the condition of the salivary glands and surrounding tissues.

If treatment is delayed or neglected, sialadenitis can progress to salivary gland abscesses or mucoceles, requiring special caution. In severe abscess cases, surgical treatment such as incision and drainage of the salivary gland may be necessary.

If salivary gland inflammation occurs frequently, maintaining oral hygiene is most important. Regularly massaging the painful area with a warm towel and consuming sour foods like vinegar, lime, or lemon can help stimulate saliva secretion.

Preventive measures include ▲clean oral care ▲adequate hydration ▲quitting smoking ▲avoiding spicy foods ▲maintaining immunity ▲and sufficient nutrition.