eMedicine Specialties > Pediatrics: General Medicine > Infectious Disease

Mumps: Differential Diagnoses & Workup

Author: Cem S Demirci, MD, Fellow in Endocrinology, Children's Hospital of Pittsburgh
Coauthor(s): Walid Abuhammour, MD, FAAP, Associate Professor of Pediatrics, Michigan State University; Director of Pediatric Infectious Disease, Department of Pediatrics, Hurley Medical Center
Contributor Information and Disclosures

Updated: Nov 20, 2009

Differential Diagnoses

Human Immunodeficiency Virus Infection

Other Problems to Be Considered

Coxsackievirus parotitis
Influenza virus parotitis
Parainfluenza virus parotitis
Suppurative parotitis commonly caused by Staphylococcus aureus or other bacteria
Adenitis
Recurrent parotitis
Calculus of Stensen duct
Tumors of the parotid gland
Mikulicz syndrome
Meningoencephalitis

Workup

Laboratory Studies

  • Diagnosis of mumps is clinical, and laboratory tests are unnecessary. The virus can be isolated from saliva or mouth washings in primary monkey kidney tissue culture.
  • Diagnosis can also be made by significant rise between acute and convalescent phase titers in serum mumps immunoglobulin G (IgG) antibody level using any standard serologic assay or positive serologic test for mumps immunoglobulin M (IgM) antibody. Interpretation of titer rise may have limitations because of mumps cross-reaction with parainfluenza viruses.
  • Serum amylase is elevated in mumps parotitis and pancreatitis. Serum lipase is elevated in pancreatitis.
  • CBC count reveals a normal or elevated WBC count with lymphocyte predominance.
  • Viruria is common even in uncomplicated mumps.

Imaging Studies

  • Imaging may only be needed for complicated cases that involve certain organ systems.

Other Tests

  • Complicated cases may need further testing, if determining organ system involvement is necessary.

Procedures

  • Lumbar puncture may be needed to obtain cell profile and culture information if meningoencephalitis is the prominent presentation.

More on Mumps

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

  1. CDC. Mumps--United States, 1985-1988. MMWR Morb Mortal Wkly Rep. Feb 24 1989;38(7):101-5. [Medline].

  2. [Guideline] Watson JC, Hadler SC, Dykewicz CA, et al. Measles, mumps, and rubella--vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR - Morbidity & Mortality Weekly Report. May 22 1998;47(RR-8):1-57. [Medline].

  3. Hopkins RS, Jajosky RA, Hall PA, et al. Summary of notifiable diseases--United States, 2003. MMWR Morb Mortal Wkly Rep. Apr 22 2005;52(54):1-85. [Medline].

  4. CDC. Mumps outbreak at a summer camp--New York, 2005. MMWR Morb Mortal Wkly Rep. Feb 24 2006;55(7):175-7. [Medline]. [Full Text].

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

  6. CDC. Mumps epidemic--United kingdom, 2004-2005. MMWR Morb Mortal Wkly Rep. Feb 24 2006;55(7):173-5. [Medline]. [Full Text].

  7. Shanley JD. The resurgence of mumps in young adults and adolescents. Cleve Clin J Med. Jan 2007;74(1):42-4, 47-8. [Medline].

  8. Hatchette TF, Mahony JB, Chong S, LeBlanc JJ. Difficulty with mumps diagnosis: what is the contribution of mumps mimickers?. J Clin Virol. Dec 2009;46(4):381-3. [Medline].

  9. [Guideline] Update: recommendations from the Advisory Committee on Immunization Practices (ACIP) regarding administration of combination MMRV vaccine. MMWR Morb Mortal Wkly Rep. Mar 14 2008;57(10):258-60. [Medline].

  10. AAP. Mumps. In: Red Book: Report of the Committee on Infectious Diseases. 26th ed. Elk Grove, IL: American Academy of Pediatrics; 2003:439-43.

  11. CDC. Brief report: update: mumps activity--United States, January 1-October 7, 2006. MMWR Morb Mortal Wkly Rep. Oct 27 2006;55(42):1152-3. [Medline]. [Full Text].

  12. [Guideline] CDC. Mumps prevention. MMWR Morb Mortal Wkly Rep. Jun 9 1989;38(22):388-92, 397-400. [Medline].

  13. CDC. 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].

  14. CDC. Update: childhood vaccine-preventable diseases--United States, 1994. MMWR Morb Mortal Wkly Rep. Oct 7 1994;43(39):718-20. [Medline].

  15. Chaiken BP, Williams NM, Preblud SR, et al. The effect of a school entry law on mumps activity in a school district. JAMA. May 8 1987;257(18):2455-8. [Medline].

  16. Cherry JD. Mumps Virus. In: Feigin RD, Cherry JD, eds. Textbook of Pediatric Infectious Disease. 2nd ed. Philadelphia, PA: WB Saunders; 1998:2075-83.

  17. Maldonado Y, Phillips C. Mumps. In: Behrman RE, ed. Nelson Textbook of Pediatrics. Philadelphia, PA: WB Saunders; 1996:873-75.

  18. McQuone SJ. Acute viral and bacterial infections of the salivary glands. Otolaryngologic Clinics of North America. Oct. 1999;32(5):793-811. [Medline].

  19. Ornoy A, Tenenbaum A. Pregnancy outcome following infections by coxsackie, echo, measles, mumps, hepatitis, polio and encephalitis viruses. Reprod Toxicol. May 2006;21(4):446-57. [Medline].

  20. Sosin DM, Cochi SL, Gunn RA, et al. Changing epidemiology of mumps and its impact on university campuses. Pediatrics. Nov 1989;84(5):779-84. [Medline].

  21. Taber LH, Demmler GJ. Mumps. In: McMillan JA, DeAngelis CD, Feigin R, Warshaw JB, eds. Oski's Pediatrics. Philadelphia, PA: Lippincott Williams & Wilkins; 1999:1141-2.

  22. van Loon FP, Holmes SJ, Sirotkin BI, Williams WW, Cochi SL, Hadler SC. Mumps surveillance--United States, 1988-1993. MMWR CDC Surveill Summ. Aug 11 1995;44(3):1-14. [Medline].

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Further Reading

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Keywords

mumps, parotitis, epidemic parotiditis, measles-mumps-rubella vaccine, MMR vaccine, mumps virus, mumps encephalitis, meningitis, transient myelitis, polyneuritis, oophoritis, myocarditis, nephritis, arthritis, thyroiditis, pancreatitis, thrombocytopenia purpura, mastitis, pneumonia, parotitis, orchitis, meningoencephalitis

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Contributor Information and Disclosures

Author

Cem S Demirci, MD, Fellow in Endocrinology, Children's Hospital of Pittsburgh
Disclosure: Nothing to disclose.

Coauthor(s)

Walid Abuhammour, MD, FAAP, Associate Professor of Pediatrics, Michigan State University; Director of Pediatric Infectious Disease, Department of Pediatrics, Hurley Medical Center
Walid Abuhammour, MD, FAAP is a member of the following medical societies: American Medical Association and Pediatric Infectious Diseases Society
Disclosure: Nothing to disclose.

Medical Editor

Gary J Noel, MD, Department of Pediatrics, Clinical Associate Professor, Weill Medical College of Cornell University
Gary J Noel, MD is a member of the following medical societies: Pediatric Infectious Diseases Society
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

Mark R Schleiss, MD, American Legion Chair of Pediatrics, Professor of Pediatrics, Division Director, Division of Infectious Diseases and Immunology, Department of Pediatrics, University of Minnesota Medical School
Mark R Schleiss, MD is a member of the following medical societies: American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Society for Pediatric Research
Disclosure: Nothing to disclose.

CME Editor

Robert W Tolan Jr, MD, Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine
Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility
Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; sanofi pasteur Honoraria Speaking and teaching; Baxter Healthcare Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD, Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine
Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association
Disclosure: None None None

 
 
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