Diagnosis

Mumps

Etiology

Cause

• Paramyxovirus (Rubulavirus)

Pathophysiology

1. Incubation period of 12 to 25 days

2. Contagious from 2 days before the onset of symptoms through 5 days after onset

3. Prodrome phase:

   • Primary replication in the upper airway mucosal epithelium

   • Infection of mononuclear cells in regional lymph nodes --> viremia

   • Nonspecific symptoms: fever, malaise, headache, myalgia, and anorexia

4. Viremic dissemination to the salivary glands, CNS, testes, ovaries, pancreas, mammae

   • Inflammation and edema --> cell necrosis, hemorrhage and destruction

Complications [uat]

• Meningitis/encephalitis

• Myelitis

• Polyneuritis

• Guillain-Barre syndrome

• Keratouveitis

• Thyroiditis

• Myocarditis

• Mastitis

• Pneumonia

• Pancreatitis

• Nephritis

• Orchitis

• Oophoritis

• Arthritis

• Thrombocytopenia --> purpura

• Hearing loss

Risk factors [uat]

• Immunodeficiency

• International travel

• Living in a crowded setting

• Lack of vaccination

Epidemiology

Incidence per 100.000 [khm][tfu][zsk][on4][q8q]

Approach

• Blood test: WBC, CRP, ESR, amylase, lipase

• Nasopharyngeal swabs

  • PCR

  • Antibody titers (IgM)

• Urine: viruria

Treatment

1. Profylaxis: measles-mumps-rubella (MMR) vaccine [7zr]

   • Incidence in Shanghai decreased from 247.6 (1990) to 11.0 (2015) per 100,000 [zsk]

2. Self-limited disease --> No antiviral agent is indicated

3. Supportive care: [uat]

   • Adequate hydration

   • Analgesics (acetaminophen, ibuprofen)

   • Topical application of warm or cold packs

   • Bed rest

   • Scrotal support

Differential diagnoses

Acute pancreatitis, Adenovirus, Allergy, Anaphylaxis, Benign tumors of salivary glands, Cytomegalovirus, Dental infection, Drug side effects, Encephalitis, Epididymitis, Hemangioma, Herpes simplex, Herpes zoster, HIV, Influenza, Kawasaki disease, Lymphadenopathy, Lymphangioma, Lymphoma, Malignant tumors of salivary glands, Mastoiditis, Measles, Meningitis, Mikulicz syndrome, Mononucleosis, Myocarditis, Orchitis, Ovarian torsion, Parotitis, Pertussis, Roseola infantum, Rubella, Sialadenitis, Sialolithiasis, Sjogren syndrome