eMedicine Specialties > Emergency Medicine > Infectious Diseases

Mumps: Follow-up

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

Follow-up

Further Inpatient Care

  • Patients with specific complications may require further inpatient care.
  • Persons with encephalitis, meningitis, nephritis, myocarditis, or severe pancreatitis require more supportive care.

Further Outpatient Care

  • Classic mumps with no major complications can be managed on an outpatient basis with supportive care and good follow up.
  • Scrotal support, ice, and analgesia
  • Hearing tests in young children

Transfer

  • Transfer is rarely needed. Indication to transfer would be if major complications are present and current hospital does not have appropriate services to treat the patient appropriately.

Deterrence/Prevention

  • Vaccination remains the best protection. The Centers for Disease Control and Prevention posts the latest immunization schedules on their Web site.
  • Isolate persons who have virus while hospitalized.

Complications

  • Meningoencephalitis: Although most patients recover without prolonged sequela, the mortality rate has been reported to be up to 1.4%.9
  • Orchitis: This is the most common complication in the pediatric population. This does not usually result in sterility. Ultrasonography may be indicated when orchitis is clinically identified to rule out torsion.
  • Oophoritis
  • Pancreatitis
  • Transverse myelitis
  • Cerebellar ataxia
  • Myocarditis
  • Sensorineural hearing loss
  • Additional rare complications include nephritis, arthritis, thrombocytopenic purpura, mastitis, thyroiditis, and keratouveitis.

Prognosis

  • Prognosis for mumps infection is usually good.
  • The most serious complication is encephalitis, with a mortality rate of 1.4%.
  • Orchitis can cause sterility if bilateral.
  • Transient sensorineural loss occurs in 4% of adults.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Medicolegal pitfalls relate more to the complications of mumps such as CNS or orchitis.
 


More on Mumps

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

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Further Reading

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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

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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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