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Mumps--Physical
Findings and Complications of Mumps
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to Q&As about:
What
are the typical physical findings
of mumps infection?
Mumps
usually involves pain, tenderness and
swelling in one or both parotid salivary
glands. Swelling is first visible in front
of the lower part of the ear. Swelling
than extends downward and forward as fluid
builds up in the skin and soft tissue
of the face and neck. Swelling
usually peaks in 1-3 days and then subsides
during the next week. The
swollen tissue pushes the angle of the
ear up and out. As swelling worsens, the
angle of the jawbone (mandible) below
the ear is no longer visible. On
palpation, often the jawbone cannot be
felt because of swelling of the parotid. One
parotid may swell before the other, and
in 25% of patients, only one side swells.
Other salivary glands (submandibular and
sublingual) under the floor of the mouth
also may swell but do so less frequently
(10%). |
Mumps
infection is most often confused with swelling
of the lymph nodes of the neck. Lymph node
swelling can be differentiated by the well-defined
borders of the lymph nodes, their location
behind the angle of the jawbone, and lack
of the ear protrusion or obscuring of the
angle of the jaw, which are characteristics
of mumps.
What
are other clinical findings or complications
that may be associated with mumps?
In 50% – 60% of cases of clinical mumps, cerebrospinal
fluid (CSF) pleocytosis occurs. However,
clinical evidence of meningitis or encephalitis
appears in < 10% of patients with mumps. Serious
sequelae are rare. For example, deafness
after mumps occurs in 0.5 to 5.0 per 100,000
cases. Death occurs in < 2% of mumps
encephalitis cases.
Orchitis occurs in about 25% of adolescent and adult
males with mumps and is rare in prepubescent
males. One or both testes may be involved,
with lower abdominal pain, fever, and chills
and possibly epididymitis. The involved
testis and adjacent skin become swollen
and red. Orchitis occurs within 1 week
of parotitis and usually lasts 4 days. Infertility
is rare even when both testes are involved.
Oophoritis occurs in 5% of post pubertal females
with mumps and is characterized by pelvic
pain and tenderness. Infertility generally
does not occur. Mastitis may also occur.
Less common complications of mumps infection include
pancreatitis, myocarditis, arthritis, thyroiditis,
deafness, and spontaneous abortion.
For more information see pediatric infectious disease
texts, for example:
Cherry JD. Mumps virus. In: Feigin RD,
Cherry JD, Demmler GJ, Kaplan SL, eds. Textbok
of Pediatric Infectious Diseases. 5th
ed. Philadelphia, Penn: Saunders;
2004:2305–2314.
Gutierrez K. Mumps virus. In: Long SS,
Pickering LK, Prober CG, eds. Principles
and Practices of Pediatric Infectious
Diseases. 2nd ed. Philadelphia,
Penn: Churchill Livingstone; 2003:1136–1140.
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