bubble_chart Overview

Mumps (epidemic parotitis) is a respiratory infectious disease caused by the mumps virus. It spreads through droplets. The virus enters the bloodstream and primarily affects salivary glands such as the parotid, submandibular, and sublingual glands, followed by the gonads, pancreas, thyroid, and lacrimal glands. Other organs such as the brain, meninges, myocardium, liver, and kidneys can also be affected.

bubble_chart Epidemiology

It is most common in children aged 5 to 9, can occur in all seasons, but is more prevalent in winter and spring, and may cause small outbreaks among groups of children.

bubble_chart Clinical Manifestations

1. Most children begin the illness with parotid gland swelling. Initially, one side swells, followed by the other side within 1–4 days. The swelling spreads diffusely around the earlobe, forward and backward, with indistinct edges. There is no local redness, but grade I tenderness and an elastic sensation are present.
2. A few children initially experience fever, loss of appetite, headache, sore throat, and vomiting, followed by parotid gland swelling within hours to 2 days. The swelling peaks in 1–3 days and persists for 4–5 days.
3. The affected area is painful when chewing or consuming acidic foods. The opening of the parotid duct near the second molar on the buccal mucosa becomes red and swollen. The submandibular and sublingual glands may also swell, with redness at their openings. The enlarged submandibular glands can be palpated deep under both jaws—firm, with mild tenderness and immobility.
4. Complete resolution of swelling takes about 8–10 days, and systemic symptoms subside accordingly. In some cases, lumps may remain in the parotid or submandibular glands for an extended period.

bubble_chart Auxiliary Examination

1. The white blood cell count is normal or slightly low, with a relative increase in lymphocytes. In cases such as meningoencephalitis, orchitis, or pancreatitis, the white blood cell count may increase.
2. Hematuria and elevated amylase levels, particularly significantly elevated in cases complicated by pancreatitis.
3. An increase in serum lipase is helpful in the diagnosis of pancreatitis.
4. Serological tests, including complement fixation tests and hemagglutination inhibition tests, using paired sera with a fourfold or greater increase in titer or a titer of 1:64 or higher, have diagnostic value.
5. Virus isolation can be performed from the saliva, blood, urine, or cerebrospinal fluid of early-stage patients.
6. For cases complicated by meningoencephalitis, lumbar puncture may reveal slightly increased pressure, slightly elevated cerebrospinal fluid cell counts (predominantly lymphocytes), normal or slightly increased protein levels, and normal glucose levels.

bubble_chart Diagnosis

History of exposure to mumps. Incubation period is 14-21 days.

bubble_chart Treatment Measures

﹝Treatment﹞

(1) Pay attention to oral hygiene, consume semi-liquid and liquid foods, and reduce intake of acidic foods. (2) Drug treatment

1. Moroxydine 10mg/(kg·d) is effective against mumps virus.
2. Administer antipyretics such as aspirin.
3. Mumps tablets, 3–5 tablets per dose, three times daily, for clearing heat and removing toxins to reduce swelling, suitable for older children.
4. Antiviral oral liquid (containing Isatis Root, Gypsum, Reed Rhizome, Unprocessed Rehmannia Root, Patchouli, Forsythia, etc.) 10–20ml per dose, taken orally 2–3 times daily. (3) Treatment of complications: 1

． For meningoencephalitis, provide symptomatic treatment. In severe cases with high intracranial pressure, administer dehydrating agents (same as treatment for "Japanese encephalitis"). 2． For pancreatitis, implement fasting and intravenous fluids, monitor fluid and electrolyte balance, and begin semi-liquid or liquid diet once symptoms improve. 3． For orchitis, support the scrotum with a T-bandage. In cases of high fever and severe pain, oral prednisone may be given at 1 mg/kg.

bubble_chart Prevention

(1) The child should be isolated until the parotid gland swelling completely subsides.

(2) Contacts should be quarantined for 21 days. Take Isatis Root infusion granule or moroxydine orally.

(3) The child's utensils should be disinfected by boiling or exposure to sunlight.

(4) A triple combination vaccine is already available abroad with good preventive effects, and a domestic attenuated live vaccine has also been successfully developed, awaiting promotion.

bubble_chart Complications

1. Brain membrane Encephalitis manifests as high fever, headache, drowsiness, vomiting, and signs of brain membrane irritation. It mostly occurs during the swelling of the parotid gland but can also appear up to 6 days before the gland enlarges. If it occurs before the parotid swelling, it can easily be confused with other viral encephalitis. A definitive diagnosis can only be made after the parotid gland swells. Recovery typically takes about 10 days.
2. Orchitis or oophoritis Mostly occurs in children over 12 years old and adolescent patients. When the swelling of the parotid gland subsides, fever recurs, accompanied by localized pain and unilateral or bilateral testicular swelling. A small number of cases involving both sides may lead to testicular atrophy. Oophoritis in girls is rare, with mild symptoms such as lower back pain, making it difficult to diagnose.
3. Pancreatitis During the course of the illness, fever rises again, accompanied by nausea, vomiting, persistent upper abdominal pain, abdominal distension, and fullness. Examination reveals muscle tension and tenderness.
4. Myocarditis, thyroiditis, nephritis, and thrombocytopenic purpura are relatively rare complications.

bubble_chart Differentiation

(1) Suppurative parotitis is limited to one side, with obvious local redness, swelling, heat, and pain. Fluctuation may be present when an abscess forms, and pus may be discharged from the parotid duct upon compression. Total white blood cell count and neutrophils are elevated. (2) Preauricular lymphadenitis presents with swelling in front of the ear, where a well-defined, nodular gland can be palpated with tenderness. (3) Cervical lymphadenitis manifests as swelling below the mandible, farther from the lower ear. The oral mucosa, throat, or tonsils often have concurrent inflammatory lesions. Differentiation from submandibular gland inflammation is necessary. (4) Symptomatic parotid swelling is usually bilateral, soft, and non-tender. It may occur in patients with diabetes, chronic liver disease, malnutrition, or those taking medications such as iodides or hydroxyphenylbutazone. (5) Parotid duct obstruction causes glandular swelling due to blockage. (6) Mikulicz syndrome: Acute granulocytic leukemia infiltration can lead to symmetrical enlargement of the salivary glands (parotid and submandibular) and lacrimal glands. Affected children experience dry mouth and difficulty chewing, which rapidly improve and resolve after antileukemic chemotherapy.