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Syphilis of the salivary glands
Last reviewed: 23.04.2024
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Syphilis of the salivary glands (lyus salivary glands) is a chronic venereal disease caused by pale treponema, characterized by damage to the skin, mucous membranes, internal organs and the nervous system.
Syphilitic sialadenitis is rare (0.5% of all salivary gland diseases). Some authors (Lvov PP, 1938) believed that there is immunity of the salivary glands to syphilitic damage.
Symptoms of syphilis of the salivary glands
The disease manifests itself in the form of an aftergrowth, often bilateral sialadenitis, accompanied by increased salivation, pain during chewing, swallowing and palpation of the salivary gland. The latter slowly increases and thickens. Regional lymph nodes are enlarged, compacted, painless. If specific treatment with mercury preparations is carried out, then abscessing of the lymph nodes adjacent to the salivary gland may occur. This fact gave grounds to some authors to assert that in the secondary period of syphilis the inflammation of the salivary gland is banal in nature and is associated with the specific treatment being carried out.
In the Tertiary period, the development of gum is noted, leading to partial death of the parenchyma of the gland and subsequent scarring. With gum under the mandibular gland, in case of congenital syphilis, the iron is painless, unevenly compacted. In the anterior section of her department there was a softening, with the puncture of which a liquid was obtained, apparently saliva, poured out in the region of the decayed gum. With sialography, defects in the filling of the parenchyma of the gland were found. The ducts are deformed, in the anterior lower part of the cavity at the place of the filling defect, rounded cavities were defined.
According to the literature, gummous sialadenite is characterized by painful swelling of the salivary gland and development of a tumor-like node in it. Further the site is softened and resolved in the form of ulceration and fistula formation. In the pathological process, surrounding tissues can be involved. With syphilitic interstitial sialadenitis, the salivary gland slowly increases. It is dense, painless and soldered to surrounding tissues, and therefore has limited mobility. With this form of sialadenitis, abscess formation is not observed.
Diagnosis of salivary gland syphilis
Diagnosis of syphilis salivary gland is difficult. The process has many common signs with chronic sialadenitis, actinomycosis, tuberculosis and malignant tumors of the salivary glands. Significant importance has anamnestic data, manifestation of the disease in other parts of the body, positive laboratory data (serological reactions). The effect of specific therapy also serves as evidence of a syphilitic process. The histological examination of the biopsy material finally confirms the diagnosis. Microscopically, in some cases, focal softening (gumma) is noted, and in others - the growth of the inflammatory stroma and associated changes in the structure of the gland. In large vessels, changes occur in the type of endarteritis and endophlebitis. There is a significant development of connective tissue around the capillaries.
[Treatment and prognosis of salivary gland syphilis
Treatment of syphilis of the salivary glands is carried out together with the dermatovenerologist.
The prognosis for syphilis of the salivary glands in the case of timely treatment is more favorable than in patients who refused treatment. Late treatment begins leading to the rapid development of severe ophthalmic, dental and systemic manifestations of the disease and disability in the future.