I am the CG to my wife who was was diagnosed in 2005 with left later tongue cancer and underwent surgery radiation and chemo.

She has had pain in the right jaw and below the jaw since early July 2010. We saw her dentist and her ENT in July who treated the pain with antibiotics.

We saw the ENT this week and he indicated that the salivary gland below the right jaw has in essence stopped working. Since there is no saliva flow, bacteria has entered the gland and caused the infection and resulting pain.

He prescribed Augumetin in 2000 mg daily dosage saying that this may help but he was not hopeful since that gland will have to be surgically removed.

There has been no improvement in the pain with the Augumentin. I would appreciate knowing from other members their experience with post treatments salivary gland infections, treatments, surgeries, recovery and complications post surgery.

Thank you for your help. I appreciate it.

I am surprised that the antibiotics have had zero impact. I would have expected something. So that makes me wonder if it is just the wrong antibiotic for the infections ( there are gram positive and gram negative bacteria each requiring different antibiotics) , or if it is not an infection at all.

The surgery to remove a small salivary gland is a minor procedure, and the mouth recovers amazingly fast compared to other parts of the body. I think I would want two things, a head and neck CT/or MRI with contrast, to see that this is all things are, and this is all that is going on. The second thing is that the excised material to be sent for a full pathology work up, so that you will have an unambiguous answer to determine what it was.

Vin,
Agreed that scanning is a good option to see if there's a reason, such as a blockage,for the infection. Even without flow, salivary glands do not usually get an infection that is not treatable. Change in antibiotics is also a good suggestion, especially if an organism can be cultured from the infected gland.
Irrigation of the gland is possible (by your oral surgeon or ENT) by using the small ductal opening in your mouth. If an obstruction is there, it can be flushed out. Some people have inflammed parotid ducts that can be helped using a steroid irrigation. As Brian suggests, the best idea would be to find out why or what organism is causing the inflammation and pain.
Hope things improve for your wife.

Brian,

Thank you for your reply and comments. I appreciate it.

The pain had almost gone away on Tuesday but came back strong on Wednesday. I spoke with the ENT staff today and the ENT recomemndation was to continue with the antibiotics for the full two weeks regimen. We will discuss the CT or MRI with the ENT at our follow up visit next Wednesday.

Again, thank you.

Linda,

Thank you for the suggestion on the irrigation of the gland. We will also discuss this approach with the ENT. I was not aware that this was an option and I am thankful for your reply.

Since my last post, we saw the ENT again and he recommended to continue to take the Augmentin and we were also scheduled for surgery the morning of September 8 to remove the salivary gland. The ENT indicated that we could cancel the surgery if the infection had gotten better or gone away.

The morning of September 8, my wife was prepped for surgery and the IV was placed. The ENT came by and asked my wife why her lips were swollen. They had been for a couple of days. She wanted to know from him since he is the doctor. He said he did not know and this worried him since the the swelling and pain in the area of the right jawbone were still there.

He left and sometimes later sent his young resident to visit with my wife. The resident did a visual/feel exam of the right cheek area and left to confer with the ENT.

The resident came back and said that the surgery was off. They wanted to the right thing for my wife. The resident proceeded to say that this may be cancer so they sent us immediately for a CT scan although the ENT by now had had over two months to order one. We did the scan that same morning.

The next day the ENT calls my wife and says that the CT showed "Diffuse
Cellulitis" and for her to keep taking the Augmentin.

We saw the doctor last week and again no improvement. Upon our request, he prescribed a new antibiotic, Avelox, 400 mg daily dose.

There was a mild improvement but this morning she woke up with the right side of her face very swollen and in pain. She no longer has any feeling in the area below her bottom lip. I contacted the ENT and he said he was going to order a PET/CT.

We are frustrated and worried. This has been going on since early July and there is no progress. We asked the ENT on several occasions as to what happens if this infection does not go away. He replies that he has never seen that happen and at the most the infection will form an abscess which will need to be drained.

At one of our visits about a month ago, I asked the ENT to hospitalize my wife so she could get the antibiotics through an IV directly into the blood stream. He did not agree with me.

I would appreciate any help or assistance with anyone who has experienced "Diffuse Cellulitis" since we have ran into a block wall with our ENT. Please help.

Thank you.