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-hours later develop salivary gland swelling
- Parotitis (can be unilateral, bilateral)- lasts up to 10 days
- Usually self limiting
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
- 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
- Ranula
- Sialoadenitis
- Sialolithiasis
- Superior vena cava syndrome
Testicular Diagnoses
- Scrotal cellulitis
- Epididymitis
- Fournier gangrene
- Hematocele
- Hydrocele
- 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
Disposition
- Typically treated as an outpatient
- Consider admission for serious complications (e.g., meningitis, encephalitis, myocarditis, nephritis, pancreatitis)