Salivary gland syphilis

Syphilis of the salivary glands (salivary gland lues) is a chronic venereal disease caused by pale treponema, characterized by lesions of the skin, mucous membranes, internal organs and nervous system.

Syphilitic sialadenitis is rare (0.5% of all salivary gland diseases). Some authors (Lvov P.P., 1938) believed that there is immunity of the salivary glands to syphilitic lesions.

Symptoms of syphilis of the salivary glands

The disease manifests itself in the form of acute, often bilateral sialadenitis, accompanied by increased salivation, pain when chewing, swallowing and palpation of the salivary gland. The latter slowly increases in size and becomes denser. Regional lymph nodes are enlarged, denser, and painless. If specific treatment with mercury preparations is carried out, abscessing of the lymph nodes adjacent to the salivary gland may occur. This fact has given grounds for some authors to assert that in the secondary period of syphilis, inflammation of the salivary gland is banal and is associated with the specific treatment that was carried out.

In the tertiary period, gummas develop, leading to partial death of the gland parenchyma and subsequent scarring. In the case of gumma of the submandibular gland, in the case of congenital syphilis, the gland is painless, unevenly compacted. In its anterior lower section there was softening, upon puncture of which a liquid was obtained, apparently saliva, pouring out in the area of the disintegrated gumma. Sialography revealed defects in the filling of the parenchyma of the gland. The ducts are deformed, in the anterior lower section at the site of the filling defect, cavities of a rounded shape were determined.

According to the literature, gummatous sialadenitis is characterized by painful swelling of the salivary gland and the development of a tumor-like node in it. Later, the node softens and resolves in the form of ulceration and the formation of a fistula. Surrounding tissues may be involved in the pathological process. In syphilitic interstitial sialadenitis, the salivary gland slowly increases in size. It is dense, painless and fused with surrounding tissues, and therefore has limited mobility. With this form of sialadenitis, abscess formation is not observed.

Diagnosis of syphilis of the salivary glands

Diagnosis of syphilis of the salivary gland is difficult. The process has many common features with chronic sialadenitis, actinomycosis, tuberculosis and malignant tumors of the salivary glands. Anamnestic data, manifestation of the disease in other parts of the body, positive laboratory test results (serological reactions) are of great importance. The effect of specific therapy also serves as evidence of the syphilitic process. Histological examination of biopsy material finally confirms the diagnosis. In this case, microscopically, in some cases focal softening (gumma) is noted, and in others - the growth of inflammatory stroma and associated changes in the structure of the gland. In large vessels, changes occur according to the type of endarteritis and endophlebitis. Significant development of connective tissue around the capillaries is observed.

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Treatment and prognosis of syphilis of the salivary glands

Treatment of syphilis of the salivary glands is carried out in conjunction with a dermatovenerologist.

The prognosis for syphilis of the salivary glands in the case of timely treatment is more favorable than in patients who refuse treatment. Late treatment leads to the rapid development of severe ophthalmological, dental and systemic manifestations of the disease and subsequent disability.