Mumps

Mumps (acute viral sialadenitis: epidemic parotitis) is an acute infectious disease which affects principally the major salivary salivary glands.

Mumps

Aetiopathogenesis

Mumps is caused by an RNA paramyxovirus transmitted by direct contact or by droplet spread from saliva but some Coxsackie, ECHO- and other viruses occasionally cause similar features. 

Clinical Features

A longish incubation period of 2–3 weeks is followed by an acute onset of

• painful salivary swelling (parotitis) usually bilaterally, although in the early stages only one parotid gland may appear to be involved ( Fig. 2.7.34 ). In approximately 10% of cases the submandibular glands are also affected and rarely these may be the only glands involved. The salivary swelling persists for about 7 days and then gradually subsides. The most obvious intraoral feature is swelling and redness at the duct orifice of the affected gland (papillitis)
• trismus
• fever
• malaise.

Mumps less commonly and mainly in adults has extrasalivary manifestations which can include:

• orchitis (ensuing infertility is rare)
• pancreatitis
• meningoencephalitis
• oophoritis and thyroiditis (ensuing infertility is rare)
• glomerulonephritis—especially in immunocompromised persons.

Diagnosis

The diagnosis is on clinical grounds but confirmation, if needed, is by demonstrating a four–fold rise in serum antibody titres to mumps S and V antigens between acute serum and convalescent serum taken 3 weeks later.

A similar clinical picture can arise with radioactive iodine therapy (‘iodine mumps’), as salivary gland swelling and possible xerostomia that lasts for about 7 days. Rarely these features persist and cause
permanent loss of function of one or more gland.

Management

No specific antiviral agents are available. Treatment is, therefore, symptomatic involving

• analgesics
• adequate hydration
• reducing the fever.

Reference : Scull C, et al. 2010. Oral  and Maxillofacial Disease. Vol. 4th Ed. Informa Healthcare. UK