eMedicine Specialties > Emergency Medicine > Infectious Diseases

Mumps: Differential Diagnoses & Workup

Author: Kristin A Carmody, MD, Assistant Professor, Boston University Medical School; Attending Physician, Department of Emergency Medicine and Associate Director of Emergency Ultrasound, Boston Medical Center
Coauthor(s): Richard H Sinert, DO, Associate Professor of Emergency Medicine, Clinical Assistant Professor of Medicine, Research Director, State University of New York College of Medicine; Consulting Staff, Department of Emergency Medicine, Kings County Hospital Center
Contributor Information and Disclosures

Updated: Mar 23, 2009

Differential Diagnoses

Encephalitis
Myocarditis
Epididymitis
Orchitis
Mastoiditis
Ovarian Torsion
Meningitis
Sjogren Syndrome

Other Problems to Be Considered

Bacterial (suppurative) parotitis
Parotid duct stone
Drug reactions
Parotid tumor
Cervical lymphadenitis
Cytomegalovirus
Mikulicz syndrome

Workup

Laboratory Studies

  • Diagnosis is usually clinical. Laboratory evaluation is usually undertaken in the ED to look for other causes of a patient's symptoms or to evaluate for complications or comorbidity. Mumps-specific tests are generally performed on an outpatient basis.
  • Mumps virus can be isolated from nasopharyngeal swabs, urine, blood, and fluid from buccal cavity typically from 7 days before up until 9 days after the onset of parotitis.
  • Mumps infection can be confirmed by demonstrating significant rise in mumps specific immunoglobulin G (IgG) antibody between acute and convalescent titers or a positive mumps immunoglobulin M (IgM). IgG titer can be detected by complement fixation, hemaglutination inhibition, or enzyme immunoassay.
  • Polymerase chain reaction (PCR) can be used to detect viral antigen.
  • A lymphocytosis or leukopenia may be present.
  • Serum amylase level may be elevated.
  • CNS infections usually exhibit a lymphocytic pleocytosis.

Imaging Studies

  • No specific imaging studies are diagnostic.
  • Imaging studies may be needed as a further workup with certain complications of mumps.
  • Testicular ultrasonography may be performed when acute orchitis is found clinically, with specific indication to rule out torsion.

More on Mumps

Overview: Mumps
Differential Diagnoses & Workup: Mumps
Treatment & Medication: Mumps
Follow-up: Mumps
References

References

  1. Caplan CE. Mumps in the era of vaccines. CMAJ. Mar 23 1999;160(6):865-6. [Medline].

  2. Recommended adult immunization schedule - United States, 2009. National Guideline Clearinghouse. Available at http://www.guideline.gov/summary/summary.aspx?doc_id=13982&nbr=007058&string=mumps. Accessed March 23, 2009.

  3. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). Update: recommendations from the Advisory Committee on Immunization Practices (ACIP) regarding administration of combination MMRV vaccine. National Guideline Clearinghouse. Available at http://www.guideline.gov/summary/summary.aspx?doc_id=12325&nbr=006390&string=mumps. Accessed March 23, 2009.

  4. Global status of mumps immunization and surveillance. Wkly Epidemiol Rec. Dec 2 2005;80(48):418-24. [Medline].

  5. CDC; MMWR Weekly. Mumps Epidemic - Iowa, 2006. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5513a3.htm. Accessed September 29, 2008.

  6. Majda-Stanislawska E. Mumps cerebellitis. Eur Neurol. 2000;43(2):117. [Medline].

  7. Nussinovitch M, Volovitz B, Varsano I. Complications of mumps requiring hospitalization in children. Eur J Pediatr. Sep 1995;154(9):732-4. [Medline].

  8. Saijo M, Fujita K. [Central nervous system infection caused by mumps virus]. Nippon Rinsho. Apr 1997;55(4):870-5. [Medline].

  9. Sonmez FM, Odemis E, Ahmetoglu A, Ayvaz A. Brainstem encephalitis and acute disseminated encephalomyelitis following mumps. Pediatr Neurol. Feb 2004;30(2):132-4. [Medline].

  10. Wharton IP, Chaudhry AH, French ME. A case of mumps epididymitis. Lancet. Feb 25 2006;367(9511):702. [Medline].

  11. Kayan A, Bellman H. Bilateral sensorineural hearing loss due to mumps. Br J Clin Pract. Dec 1990;44(12):757-9. [Medline].

  12. McQuone SJ. Acute viral and bacterial infections of the salivary glands. Otolaryngol Clin North Am. Oct 1999;32(5):793-811. [Medline].

  13. Kabakus N, Aydinoglu H, Yekeler H. Fatal mumps nephritis and myocarditis. J Trop Pediatr. Dec 1999;45(6):358-60. [Medline].

Further Reading

Keywords

mumps, mumps virus, mumps vaccine, parotitis, swollen cheeks, epidemic parotiditis, measles-mumps-rubella vaccine, MMR vaccine, vaccination, shots, paramyxovirus, meningitis, CNS involvement in mumps, orchitis, deafness, pancreatitis

Contributor Information and Disclosures

Author

Kristin A Carmody, MD, Assistant Professor, Boston University Medical School; Attending Physician, Department of Emergency Medicine and Associate Director of Emergency Ultrasound, Boston Medical Center
Kristin A Carmody, MD is a member of the following medical societies: American College of Emergency Physicians, American Institute of Ultrasound in Medicine, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Richard H Sinert, DO, Associate Professor of Emergency Medicine, Clinical Assistant Professor of Medicine, Research Director, State University of New York College of Medicine; Consulting Staff, Department of Emergency Medicine, Kings County Hospital Center
Richard H Sinert, DO is a member of the following medical societies: American College of Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Robert M McNamara, MD, FAAEM, Chair and Professor, Department of Emergency Medicine, Temple University School of Medicine
Robert M McNamara, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Medical Association, Pennsylvania Medical Society, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Jeter (Jay) Pritchard Taylor III, MD, Compliance Officer, Attending Physician, Emergency Medicine Residency, Department of Emergency Medicine, Palmetto Health Richland, University of South Carolina; Medical Director, Department of Emergency Medicine, Palmetto Health Baptist
Jeter (Jay) Pritchard Taylor III, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

 
 
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