ABSTRACT
Acute sialadenitis may be caused by viruses, including coronaviruses. Although there are anecdotal reports of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) salivary gland infections, there have been no well-documented cases of sialadenitis in patients with COVID-19 described in the literature. We report a case of parotitis and submandibular gland sialadenitis, as well as an isolated case of parotitis, in two patients with concurrent SARS-CoV-2 infections. Computed tomography imaging demonstrated parotid and submandibular gland enlargement with heterogenous enhancement and attenuation, consistent with sialadenitis. Medical management was sufficient for successful resolution of the acute sialadenitis. Laryngoscope, 130:2595-2597, 2020.
Subject(s)
COVID-19/complications , Parotitis/virology , SARS-CoV-2 , Sialadenitis/virology , Submandibular Gland Diseases/virology , Aged, 80 and over , COVID-19/virology , Female , Humans , Male , Middle Aged , Submandibular Gland/virologyABSTRACT
Isolated submandibular swellings pose a diagnostic challenge to the practising otolaryngologist. We report an unusual case of mumps isolated to bilateral submandibular glands. We discuss the case and the literature surrounding this condition and remind clinicians that mumps should be considered as a diagnosis in the presence of submandibular gland swelling in the absence of typical parotid swelling associated with mumps. Early consideration of this differential diagnosis, serological testing and a multidisciplinary approach may help to clinch the diagnosis earlier and prevent spread of the virus.
Subject(s)
Mumps/diagnosis , Submandibular Gland Diseases/pathology , Submandibular Gland/pathology , Submandibular Gland/virology , Aftercare , Diagnosis, Differential , Female , Humans , Lymphadenopathy/pathology , Mumps/epidemiology , Mumps/virology , Paramyxoviridae/isolation & purification , Parotid Gland/pathology , Parotid Gland/virology , Serologic Tests/methods , Submandibular Gland/diagnostic imaging , Submandibular Gland Diseases/virology , Tomography, X-Ray Computed/methods , Treatment Outcome , Young AdultABSTRACT
Viral infections are often associated with salivary gland pathology. Here we review the pathogenesis of HIV-associated salivary gland disease (HIV-SGD), a hallmark of diffuse infiltrative lymphocytosis syndrome. We investigate the presence and contributions of viral diseases to the pathogenesis of salivary gland diseases, particularly HIV-SGD. We have detected BK viral shedding in the saliva of HIV-SGD patients consistent with viral infection and replication, suggesting a role for oral transmission. For further investigation of BKV pathogenesis in salivary glands, an in vitro model of BKV infection is described. Submandibular (HSG) and parotid (HSY) gland salivary cell lines were capable of permissive BKV infection, as determined by BKV gene expression and replication. Analysis of these data collectively suggests the potential for a BKV oral route of transmission and salivary gland pathogenesis within HIV-SGD.
Subject(s)
BK Virus/pathogenicity , HIV Infections/complications , Lymphocytosis/virology , Polyomavirus Infections/complications , Saliva/virology , Salivary Gland Diseases/virology , Submandibular Gland Diseases/virology , Tumor Virus Infections/complications , Cell Line , HIV Infections/transmission , Humans , Lymphocytosis/complications , Parotid Diseases/complications , Parotid Diseases/virology , Salivary Gland Diseases/complications , Submandibular Gland Diseases/complications , Syndrome , Virus Replication , Virus SheddingABSTRACT
The submandibular and parotid glands of one of five specimens of African grass mice (Arvicanthus dembeensis) were found to be infected with cytomegaloviruses, producing a profound cytomegaly in certain cells at the juncture of secretory endpieces and intercalated ducts. These cytomegalic cells tended to have multiple nuclei, many of which contained a characteristic reticular inclusion. The viruses appeared to arise in association with the intranuclear inclusions, then passed through the nuclear envelope to the cytoplasm where they budded into Golgi saccules or into small vacuoles, presumably of Golgi origin. Fusion of small virus-carrying vacuoles led to the formation of large vacuoles containing a plethora of viruses. Viruses were liberated into gland lumina via fusion of the vacuoles with the luminal plasmalemma. Fusion of vacuoles with dehiscent ones resulted in a form of chain exocytosis. The development of cytomegaloviruses in salivary glands may differ in details in a species-specific manner.
Subject(s)
Cytomegalovirus Infections/pathology , Parotid Gland/ultrastructure , Salivary Gland Diseases/pathology , Submandibular Gland Diseases/pathology , Animals , Cytomegalovirus/ultrastructure , Cytomegalovirus Infections/virology , Female , Giant Cells , Male , Muridae , Parotid Gland/virology , Salivary Gland Diseases/virology , Submandibular Gland Diseases/virology , VacuolesABSTRACT
We reviewed the autopsy findings for the submandibular glands of 60 patients with AIDS who were autopsied at the George Washington University Medical Center (Washington, DC) from 1982 to 1992. AIDS-associated infections in the submandibular glands were compared with those in the pancreas and lung. Cytomegalovirus intranuclear inclusions were found in 10 cases, and Pneumocystis carinii infection was found in one case. Disseminated mycobacterial and fungal infections were not identified in the submandibular gland, even in the presence of documented pancreatic and pulmonary infection (P < .05). Overall, the major salivary glands of patients with AIDS are less frequently involved with disseminated opportunistic infections than is either the lung or the pancreas (P < .01 and P < .001, respectively).