It’s an acute viral infection characterized by painful enlargement of salivary glands,chiefly the parotids,as the usual presenting sign.
AETIOLOGY
•RNA virus; the virus is spread from human reservoir by direct contact, airborne droplets,fomites contaminated by saliva and possibly by urine.
•Multiply in the cells of respiratory tract, the virus is blood borne to many tissues, among which salivary and other glands are most susceptible.
•Virus is isolated from saliva as long as 6 days before and upto 9 days after appearance of salivary gland swelling.
•Transmission occurs 24 hours before occurrence of swelling or later than 3 days after it has subsided.
CLINICAL MANIFESTATION
•I.P- 14-24 days (17-18 days)
•Approximately 30-40% of infections are subclinical.in children,prodormal manifestations are rare.But may be manifest by fever, muscular pain (esp. in the neck), headeche and malaise.
SALIVARY GLAND MANIFESTATION
•The onset is usually characterized by pain and swelling in one or both parotid glands. The parotid glands swells charactersticsly: it first fill in the space between the post. Border of mandible and mastoid and then extends in a series of crescend downward and forward, being limited above by the zygoma.Oedema of skin and soft tissue swelling may proceed rapidly, reaching a maximum within a few hour, although it usually peaks in 1-3 days.The swollen tissues push the ear lobe upward and outward and the angle of the mandible is no longer visible.
DIAGNOSIS
•Diagnosis is mainly clinical.
•Routine lab tests are non specific and usually leukopenia with relative lymphocytosis.
•Elevation of serum amylase is common and returned to normal level within 2 weeks.
•Micobiologic diagnosis by serology and virus culture.
•Mumps Igà IgA and IgG
•Culture of saliva,blood.CSF,brain and the affected tissue.
DIFFERENTIAL DIAGNOSIS
•Other viral causes of paroditis-HIV, Influenza,Para influenza 1 and 3, CMV.
•Acute suppurative paroditis-Stap. aureus.
•Salivary calculus.
•Preauricular or Anterior cervical Lymphadenopathy.
TREATMENT
•There is no specific aniviral therapy. Entirely supportive bed rest as per pt. need.
•Heat and cold compression of parotid gland.
•Antipyretics-Paracetamol or Ibuprufen.
•Orchitis- local support and bed rest.
•Mumps arthritis- NSAID’s or Corticisteroids.
•Isolation- Till swelling subsides.
COMPLICATION
•Viraemia early in the infection probarbly responsible for wide spread complications.
1.Meningo encephalomyelitis-
- Most frequent.
- Primary and post infectious(demyelination)
with infection of neuron.
- Clinical manifestation occur in >10% pt.
1.Orchitis and Epididymitis-
- rare in pre adolescent boys.
- 14-35% in adolescent and adults.
- Testis is most commonly affected with or without epididymitis.Apprx. 30% cases are bilateral.Orchitis usually follows paretitis in 8 days.30-40% affected testis atrophy.
3.Oophoritis.
4.Pancreatitis.
5.Thyroditis
6.Myocarditis
7.Deafnessa
8.Occular- Dayeroadenitis
9.Arthritis- Migratory poly arthalgia(Even arthritis)
PREVENTION
•MMR in 12-15 months of age.
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