Mumps (cont.)

The diagnosis of mumps is primarily one of clinical acumen. Supportive laboratory studies are generally done to support the clinical impression. The purpose of these laboratory studies is to exclude other viruses that may give a similar clinical presentation as well as exclude very infrequent similarly presenting parotid gland enlargement (for examples, salivary gland cancer, Sjögren's syndrome, IgG-4 related disease, sarcoidosis, side effects of thiazide diuretics, etc.).

The mainstay of therapy (regardless of age range) is to provide comfort for this self-limited disease. Taking analgesics (acetaminophen, ibuprofen) and applying warm or cold packs to the swollen and inflamed salivary gland region may be helpful.

There are four serious complications of mumps: meningitis (infection of the spinal fluid which surrounds the brain and spinal cord), encephalitis (infection of the brain substance), deafness, and orchitis (infection of the testicle/testicles). All four complications may occur without the patient experiencing the classic involvement of the parotid gland.

1. Meningitis: More than 50% of patients with mumps will have meningitis, which may occur during any period of the disease. Generally patients make a full recovery without permanent side effects.
2. Encephalitis: Until the 1960s, mumps was the primary cause of confirmed viral encephalitis in the United States. Since the successful introduction of a vaccination program, the incidence of mumps encephalitis has fallen to 0.5%. Fortunately, most patients recover completely without permanent side effects.
3. Deafness: Preceding the mumps vaccination program, permanent nerve damage resulting in deafness was not unusual. While occasionally bilateral, more commonly only one ear was affected.
4. Orchitis: This complication was the most common side effect (40%) to postpubertal males who contracted mumps. Severe pain (often requiring hospitalization for pain management) was one-sided in 90% of cases. Between 30%-50% of affected testes atrophied (decreased in size), and 13% demonstrated impaired fertility. The "common knowledge" of sterility was actually rare. Previous concerns regarding mumps orchitis and later testicular cancer have not been proven. (Ovarian involvement occurred in approximately 7% of postpubertal girls.)

Less frequent complications of mumps infection include arthritis, infection of the pancreas, infection of the myocardium (heart muscle), and neurological conditions (for example, facial palsy, Guillain-Barré syndrome, etc.).

Source: MedicineNet.com
http://www.medicinenet.com/mumps/article.htm