Mumps

Background

• Contagious viral infection caused by a paramyxovirus
• Mumps cases in US range from few hundreds to thousands per year
• Highly infectious and is transmitted by respiratory droplets, direct contact, or fomites
• The incubation period is usually 16 to 18 days (range 12 to 25 days) from exposure to onset of symptom

Clinical Features

• Initially presents with headache, fever, myalgias, fatigue, anorexia
• 48 hrs later develop salivary gland swelling
• Parotitis (can be unilateral, bilateral)- lasts up to 10 days
• Usually self limiting

Patient before (left) and after (right) being infected with Mumps.

Child with mumps.

Complications

• Orchitis/oophoritis (most common complication)
  • Tends to affect post pubertal males
  • Usually occurs 5 – 10 days after parotitis and is accompanied by fever
• Neurologic complications
  • Meningitis
  • Encephalitis
  • Deafness
• Less common complications - arthritis, pancreatitis, thyroiditis, myocardial involvement

Differential Diagnosis

Bilateral Parotitis

• Viral infections
  • Viral parotitis
  • Parainfluenza
  • Coxsackie virus
  • influenza A
  • Epstein-Barr virus
  • Adenovirus
  • HIV
  • Cytomegalovirus
• Bacterial infections
  • Staphylococcus aureus
• Noninfectious
  • Salivary calculi
  • Tumors
  • Sarcoidosis
  • Sjögren’s syndrome
  • Thiazide diuretics

Facial Swelling

• Buccal space infections
• Dental problems
• Canine space infection
• Facial cellulitis
• Herpes zoster
• Masticator space infections
• Maxillofacial trauma
• Neoplasm
• Parapharyngeal space infection
• Salivary gland diagnoses
  • Parotitis
    • Bilateral parotitis
    • Suppurative parotitis
    • Viral parotitis (Mumps)
  • Ranula
  • Sialoadenitis
  • Sialolithiasis
• Superior vena cava syndrome

Testicular Diagnoses

• Scrotal cellulitis
• Epididymitis
• Fournier gangrene
• Hematocele
• Hydrocele
  • Hydrocele (peds)
• Indirect inguinal hernia
• Inguinal lymph node (Lymphadenitis)
• Orchitis
• Scrotal abscess
• Spermatocele
• Tinea cruris
• Testicular rupture
• Testicular torsion
• Testicular trauma
• Testicular tumor
• Torsion of testicular appendage
• Varicocele
• Pyocele
• Testicular malignancy
• Scrotal wall hematoma

Evaluation

• Usually clinical diagnosis- symptoms, vaccination status
• Lab testing
  • RT-PCR
  • Serology

Management

• Supportive care

See Also

• Viral parotitis
• Orchitis