eMedicine Specialties > Emergency Medicine > Pediatric

Pediatrics, Mumps: Differential Diagnoses & Workup

Author: Eileen C Quintana, MD, Assistant Professor, Departments of Pediatrics and Emergency Medicine, St Christopher's Hospital for Children
Coauthor(s): Hosseinali Shahidi, MD, MPH, Assistant Professor, Departments of Emergency Medicine and Pediatrics, State University of New York and Health Science Center at Brooklyn
Contributor Information and Disclosures

Updated: Jul 9, 2009

Differential Diagnoses

Pediatrics, Chicken Pox or Varicella
Pediatrics, Measles
Pediatrics, Meningitis and Encephalitis
Pediatrics, Pertussis
Pediatrics, Roseola Infantum
Pediatrics, Rubella

Other Problems to Be Considered

Suppurative or recurrent parotitis
Parotid calculus
Coxsackievirus infection
Parainfluenza type 3 infection
Mixed tumors, hemangiomas, lymphangiomas of the parotid gland
Mikulicz syndrome
Uveoparotid fever
Human immunodeficiency virus (HIV) infection
Meningoencephalitis
Allergic reaction, rare

Workup

Laboratory Studies

  • Generally, no laboratory studies are needed if the ED presentation is typical for mumps.
  • Mumps virus can be isolated in a cell culture inoculated with throat washings, urine, or spinal fluid.
  • Serum amylase level is elevated in mumps parotitis and pancreatitis. Serum lipase level is elevated in pancreatitis.
  • The complete blood count (CBC) may be elevated with a predominance of lymphocytes. In mumps orchitis, an elevated serum C-reactive protein level may be found.8

Imaging Studies

  • If considering meningoencephalitis, head CT, precontrast, prior to lumbar puncture, should be considered.

Other Tests

  • The complement fixation (CF), neutralization, or hemagglutination inhibition (HAI) test or an enzyme immunoassay (EIA) can be used to serologically confirm infection or vaccination.

Procedures

  • If considering meningoencephalitis, perform a lumbar puncture to eliminate causes other than mumps.

More on Pediatrics, Mumps

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

References

  1. CDC. Revised U.S. surveillance case definition for severe acute respiratory syndrome (SARS) and update on SARS cases--United States and worldwide, December 2003. MMWR Morb Mortal Wkly Rep. Dec 12 2003;52(49):1202-6. [Medline].

  2. MMWR Morb Mortal Wkly Rep. Severe acute respiratory syndrome (SARS) and coronavirus testing--United States, 2003. MMWR Morb Mortal Wkly Rep. Apr 11 2003;52(14):297-302. [Medline].

  3. Dobson R. Mumps cases rise among teenagers and young adults. BMJ. Jul 17 2004;329(7458):132. [Medline].

  4. Kancherla VS, Hanson IC. Mumps resurgence in the United States. J Allergy Clin Immunol. Oct 2006;118(4):938-41. [Medline].

  5. Koskiniemi M, Donner M, Pettay O. Clinical appearance and outcome in mumps encephalitis in children. Acta Paediatr Scand. Jul 1983;72(4):603-9. [Medline].

  6. Committee on Infectious Diseases, American Academy of Pediatrics. Report of the Committee on Infectious Diseases. In: Red Book. 2003:439-443.

  7. Hashimoto H, Fujioka M, Kinumaki H. An office-based prospective study of deafness in mumps. Pediatr Infect Dis J. Mar 2009;28(3):173-5. [Medline].

  8. Niizuma T, Terada K, Kosaka Y, Daimon Y, Inoue M, Ogita S, et al. Elevated serum C-reactive protein in mumps orchitis. Pediatr Infect Dis J. Oct 2004;23(10):971. [Medline].

  9. [Guideline] Averhoff FM, Williams WW, Hadler SC. Immunization of adolescents: recommendations of the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American Medical Association. J Sch Health. Sep 1997;67(7):298-303. [Medline].

  10. CDC Immunization Schedules. Last updated March 2009. United States Centers for Disease Control and Prevention. Available at http://www.cdc.gov/vaccines/recs/schedules/default.htm.

  11. MMWR Morb Mortal Wkly Rep. Recommended immunization schedules for persons aged 0 through 18 years --United States, 2009. MMWR Morb Mortal Wkly Rep. Jan 2 2009;57(51):[Full Text].

  12. [Guideline] CDC. Updated recommendations for isolation of persons with mumps. MMWR Morb Mortal Wkly Rep. Oct 10 2008;57(40):1103-5. [Medline].

  13. Gilgen-Anner Y, Heim M, Ledermann HP, Bircher AJ. Iodide mumps after contrast media imaging: a rare adverse effect to iodine. Ann Allergy Asthma Immunol. Jul 2007;99(1):93-8. [Medline].

  14. Gold E. Almost extinct diseases: measles, mumps, rubella, and pertussis. Pediatr Rev. Apr 1996;17(4):120-7. [Medline].

  15. Hinman A. Eradication of vaccine-preventable diseases. Annu Rev Public Health. 1999;20:211-29. [Medline].

  16. MMWR Morb Mortal Wkly Rep. Status report on the Childhood Immunization Initiative: reported cases of selected vaccine-preventable diseases--United States, 1996. MMWR Morb Mortal Wkly Rep. Jul 25 1997;46(29):665-71. [Medline].

  17. Phillips C, Behrman RE, Vaughan VC, eds. Mumps. In: Nelson's Textbook of Pediatrics. 13th ed. 1987:673-5.

  18. Sherris JC, Ryan KJ, eds. Mumps. In: Medical Microbiology: An Introduction to Infectious Diseases. 2nd ed. 1994:517-9.

Further Reading

Keywords

mumps, mumps virus, MMR, parotitis, epidemic parotiditis, measles-mumps-rubella vaccine, MMR vaccine, paramyxovirus, viremia, viruria, viral pediatric disease, live-attenuated mumps virus vaccine, meningoencephalitis, parotid gland enlargement

Contributor Information and Disclosures

Author

Eileen C Quintana, MD, Assistant Professor, Departments of Pediatrics and Emergency Medicine, St Christopher's Hospital for Children
Eileen C Quintana, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Hosseinali Shahidi, MD, MPH, Assistant Professor, Departments of Emergency Medicine and Pediatrics, State University of New York and Health Science Center at Brooklyn
Hosseinali Shahidi, MD, MPH is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, and American Public Health Association
Disclosure: Nothing to disclose.

Medical Editor

Garry Wilkes, MBBS, FACEM, Director of Emergency Medicine, Bunbury Hospital, Western Australia; Medical Director, St John Ambulance, WA Ambulance Service; Adjunct Associate Professor, Edith Cowan University; Clinical Associate Professor, Rural Clinical School, University of Western Australia, Australia.
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Grace M Young, MD, Associate Professor, Department of Pediatrics, University of Maryland Medical Center
Grace M Young, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Emergency Physicians
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

Richard G Bachur, MD, Associate Professor of Pediatrics, Harvard Medical School; Associate Chief and Fellowship Director, Attending Physician, Division of Emergency Medicine, Children's Hospital of Boston
Richard G Bachur, MD is a member of the following medical societies: American Academy of Pediatrics, Society for Academic Emergency Medicine, and Society for Pediatric Research
Disclosure: Nothing to disclose.

 
 
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