Infectious Disease Book

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Mumps

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  1. Epidemiology
    1. Peak Age 10-19 years
    2. Incidence
      1. U.S. Cases in 1968: 152,000 cases
      2. U.S. Cases in 2000: 338 cases
  2. Pathophysiology
    1. Caused by a paramyxovirus
    2. Transmission
      1. Infected Salivary secretions or urine
    3. Infectious:
      1. Start: 6 days before Parotitis
      2. Ends: 2 weeks after symptom onset
    4. Incubation: 12-25 days (typically 16-18 days)
  3. Symptoms
    1. Subclinical presentation in 20% of cases
    2. Prodrome
      1. Fever
      2. Malaise
      3. Headache
      4. Anorexia
      5. Myalgia
    3. Sudden onset pain in cheeks lasting >2 days
      1. Unilateral or bilateral
      2. Provoked by chewing or swallowing
      3. Worse with sour foods
  4. Signs
    1. Sialadenitis
      1. Parotitis occurs in 30-40% of patients
      2. Tender swelling of all Salivary Glands
      3. Skin over Parotid Gland not warm or red
        1. Contrast with Bacterial Sialadenitis
      4. Tenderness at mandibular angle
      5. Parotid duct opening appears red in Buccal mucosa
    2. Orchitis (20-35% of postpubertal males)
      1. Occurs 7-10 days after Parotitis
      2. Testicular Atrophy (50%)
      3. Sterility if bilateral involvement
  5. Complications
    1. Pancreatitis (usually uncomplicated)
    2. Central Nervous System Involvement
      1. Asymptomatic Cerebrospinal Fluid Leukocytosis (50%)
      2. Less common causes
        1. Encephalitis (1 case per 400 to 6000 Mumps cases)
          1. Mortality: 1-2% death rate from Encephalitis
        2. Paralytic Polio-like syndrome
        3. Transverse myelitis
        4. Cerebellar ataxia
    3. Miscellaneous
      1. Subacute Thyroiditis
      2. Dacryoadenitis
      3. Optic Neuritis
      4. Iritis
      5. Conjunctivitis
      6. Myocarditis
      7. Hepatitis
      8. Thrombocytopenia Purpura
      9. Interstitial Pneumonia
      10. Migratory Polyarthritis
  6. Labs
    1. Complete Blood Count
      1. Parotitis: Relative Lymphocytosis
      2. Orchitis: Marked Leukocytosis
    2. Serum Amylase increased
    3. Cerebrospinal Fluid
      1. White Blood Cells: 1000-2000 with Neutrophils
  7. Diagnosis: Culture, IgG, and IgM should all be done
    1. Culture
      1. Obtain sample within first 5 days of Parotitis
      2. Blood, Throat, CSF, Urine
      3. Immunofluorescence positive in 2-3 days
    2. Serology
      1. Mumps IgM
        1. Positive after day 3 of swelling
        2. Titers peak by one week
      2. Mumps IgG
        1. Obtain acute baseline Mumps IgG as soon as possible
        2. Check Mumps IgG again 3-5 weeks after onset
        3. Titer increases 4 fold
  8. Management
    1. Orchitis Symptomatic relief
      1. Prednisone 60 mg qd tapered over 7-10 days
  9. Prevention
    1. MMR Vaccine after age 1 year
  10. Prognosis
    1. Mortality: Up to 50 deaths per 1 million Mumps cases

Mumps (C0026780)

Definition (MSH)An acute infectious disease caused by RUBULAVIRUS, spread by direct contact, airborne droplet nuclei, fomites contaminated by infectious saliva, and perhaps urine, and usually seen in children under the age of 15, although adults may also be affected. (From Dorland, 28th ed)
Definition (CSP)acute, inflammatory, contagious disease caused by Rubulavirus and characterized by swelling of the salivary glands, especially the parotids, and sometimes of the pancreas, ovaries, or testes; spread by direct contact, airborne droplet nuclei, fomites contaminated by infectious saliva, and perhaps urine.
ConceptsDisease or Syndrome (T047)
ICD9072, 072.9
MSHD009107
BasqueGOLOA
DanishFaresyge
DutchBof
Englishepidemic parotiditis, Epidemic Parotitides, EPIDEMIC PAROTITIS, Infectious parotitis, Mumps, Mumps parotitis, Parotitis, Parotitis - epidemic
FinnishSIKOTAUTI
FrenchOreillons
GermanMumps
Hungarianparotitis epidemica
ItalianOrecchioni
NorwegianKUSMA
PortugueseParotidite epidemica/papeira
Spanishfiebre urliana, paperas, parotiditis, parotiditis epidemica, Parotiditis epidemica/paperas, parotiditis infecciosa, parotiditis urliana
SwedishPASSJUKA/PAROTITIS
Parent ConceptsVirus Diseases (C0042769), Salivary Gland Diseases (C0036093), Paramyxoviridae Infections (C0206613), OTHER DISEASES DUE TO VIRUSES AND CHLAMYDIAE (C0153111), Gastrointestinal system (C0012240), Diagnosis/Diseases Component (C0497531), Parotitis (C0030583), Rubulavirus Infections (C0376551), Mumps (C0026780), Viral infection of the digestive tract (C0729530), Infectious sialoadenitis of major salivary gland (C1290766), Duplicate concept (C1274013)
SourcesAOD, COSTAR, CSP, DXP, ICD9CM, ICPC, ICPCBAQ, ICPCDAN, ICPCDUT, ICPCFIN, ICPCFRE, ICPCGER, ICPCHUN, ICPCITA, ICPCNOR, ICPCPOR, ICPCSPA, ICPCSWE, LCH, LNC, MEDLINEPLUS, MSH, MTH, MTHICD9, NCI, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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