Mumps natural history, complications and prognosis: Difference between revisions
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{{Mumps}} | {{Mumps}} | ||
{{CMG}}; {{ | {{CMG}}; {{AE}} {{LG}}; {{NRM}} | ||
==Overview== | ==Overview== | ||
The average incubation period for mumps virus is 16-18 days. Nonspecific [[prodromal symptoms]] develop and last 3-4 days. Several days after onset of [[prodrome]], one or both of the [[Parotid gland|parotid]] salivary glands begin to swell ([[parotitis]]). One [[Parotid gland|parotid]] may swell before the other, and in 25% of patients, only one side swells. Other salivary glands ([[Submandibular gland|submandibular]] and [[Sublingual gland|sublingual]]) under the floor of the mouth also may swell but do so less frequently (10%). [[Parotitis]], lasts at least 2 days, but may persist longer than 10 days. Complications include: [[orchitis]] in post-pubertal males, [[Oophoritis]] and/or [[mastitis]] in post-pubertal females, transient [[sensorineural hearing loss]], [[Meningitis]], [[Encephalitis]], [[Pancreatitis]], and [[Spontaneous abortion]] during the first trimester of [[pregnancy]]. Mumps is [[self-limiting]] and prognosis is excellent for uncomplicated mumps. Adolescents and adults are more likely than children to develop complications but these are rare, and prognosis is still favorable. | |||
==Natural History== | |||
*The average incubation period for mumps virus is 16-18 days a range of 12-25 days. | |||
*Nonspecific [[prodromal symptoms]] develop including low-grade [[fever]] which may last 3 to 4 days, [[myalgia]], [[anorexia]], [[malaise]], and [[headache]]. | |||
*Several days after onset of [[prodrome]], one or both of the [[Parotid gland|parotid]] salivary glands begin to swell ([[parotitis]]). | |||
*Swelling is first visible in front of the lower part of the ear. It then extends downward and forward as fluid builds up in the skin and soft tissue of the face and neck. | |||
*Inflammation usually peaks in 1 to 3 days and then subsides during the next week. | |||
*Swollen tissue pushes the angle of the ear up and out. As swelling worsens, the angle of the jawbone below the ear is no longer visible. | |||
*One [[Parotid gland|parotid]] may swell before the other, and in 25% of patients, only one side swells. | |||
*Other salivary glands ([[Submandibular gland|submandibular]] and [[Sublingual gland|sublingual]]) under the floor of the mouth also may swell but do so less frequently (10%). | |||
*Parotitis, lasts at least 2 days, but may persist longer than 10 days. | |||
*Mumps infection may present only with nonspecific or primarily respiratory symptoms, or may be asymptomatic.<ref name="CDCMumps" /> | |||
==Complications== | ==Complications== | ||
*Complications may occur | *Symptoms in teenagers and adults may be more severe. | ||
*Complications are relatively rare but may occur in asymptomatic patients and are more common in people who have reached [[puberty]]. | |||
*The most common complication is [[orchitis]] in post-pubertal males.<ref name="CDCMumps">Mumps. Centers for Disease Control and Prevention (May 29, 2015). http://www.cdc.gov/mumps/index.html Accessed March 09, 2016.</ref> | |||
:*Occurs in approximately 20% of cases in this population | |||
:*Orchitis is typically unilateral and [[testicular atrophy]] may occur | |||
:*[[Infertility]] or [[subfertility]] is rare but may occur<ref>{{cite journal | author=Preveden T, Jovanovic J, Ristic D | title=Fertility in men after mumps infection without manifestations of orchitis | journal=Med Pregl | year=1996 | pages=99-102 | volume=49 | issue=3-4 | id={{PMID|8692089}} }}</ref><sup> </sup><ref>{{cite journal | author=Shakhov EV, Krupin VN | title=The clinico-statistical characteristics of the testicular generative function in male subfertility following mumps | journal=Urol Nefrol (Mosk) | year=1990 | pages=46-50 | volume= | issue=2 | id={{PMID|2368216}} }}</ref><sup> </sup><ref>{{cite journal | author=Tsvetkov D | title=Spermatological disorders in patients with postmumps orchitis | journal=Akush Ginekol (Sofiia) | year=1990 | pages=46-9 | volume=29 | issue=6 | id={{PMID|2100952}} }}</ref> | |||
*Other complications of mumps include:<ref name="pmid10063655">{{cite journal| author=Galazka AM, Robertson SE, Kraigher A| title=Mumps and mumps vaccine: a global review. | journal=Bull World Health Organ | year= 1999 | volume= 77 | issue= 1 | pages= 3-14 | pmid=10063655 | doi= | pmc=PMC2557572 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10063655 }} </ref><ref name="Gupta2005">{{cite journal|last1=Gupta|first1=R. K|title=Mumps and the UK epidemic 2005|journal=BMJ|volume=330|issue=7500|year=2005|pages=1132–1135|issn=0959-8138|doi=10.1136/bmj.330.7500.1132}}</ref> | |||
:*[[Oophoritis]] and/or [[mastitis]] in approximately 5% of post-pubertal females | |||
:*Unilateral or less common bilateral transient [[sensorineural hearing loss]] - permanent deafness has occurred but is rare<ref name="pmid19209100">{{cite journal| author=Hashimoto H, Fujioka M, Kinumaki H, Kinki Ambulatory Pediatrics Study Group| title=An office-based prospective study of deafness in mumps. | journal=Pediatr Infect Dis J | year= 2009 | volume= 28 | issue= 3 | pages= 173-5 | pmid=19209100 | doi=10.1097/INF.0b013e31818a8ca8 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19209100 }} </ref> | |||
:*[[Meningitis]] | |||
:*[[Encephalitis]] | |||
:*[[Spontaneous abortion]] in about 27% of cases during the first trimester of [[pregnancy]] | |||
:*[[Pancreatitis]] in about 5% of cases<ref name="pmid8582424">{{cite journal| author=Nussinovitch M, Volovitz B, Varsano I| title=Complications of mumps requiring hospitalization in children. | journal=Eur J Pediatr | year= 1995 | volume= 154 | issue= 9 | pages= 732-4 | pmid=8582424 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8582424 }} </ref> | |||
==Prognosis== | |||
The disease is [[self-limiting]], and the prognosis is generally good, even if other organs are involved. After the illness, life-long [[immunity (medical)|immunity]] to mumps generally occurs. [[Sterility]] in men secondary to [[testicle|testicular]] involvement and death are very rare occurrences. | |||
==Resources== | ==Resources== | ||
[http://www.cdc.gov/mumps/about/mumps-facts.html CDC: Mumps Complications] | |||
==References== | ==References== | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]; Nate Michalak, B.A.
Overview
The average incubation period for mumps virus is 16-18 days. Nonspecific prodromal symptoms develop and last 3-4 days. Several days after onset of prodrome, one or both of the parotid salivary glands begin to swell (parotitis). One parotid may swell before the other, and in 25% of patients, only one side swells. Other salivary glands (submandibular and sublingual) under the floor of the mouth also may swell but do so less frequently (10%). Parotitis, lasts at least 2 days, but may persist longer than 10 days. Complications include: orchitis in post-pubertal males, Oophoritis and/or mastitis in post-pubertal females, transient sensorineural hearing loss, Meningitis, Encephalitis, Pancreatitis, and Spontaneous abortion during the first trimester of pregnancy. Mumps is self-limiting and prognosis is excellent for uncomplicated mumps. Adolescents and adults are more likely than children to develop complications but these are rare, and prognosis is still favorable.
Natural History
- The average incubation period for mumps virus is 16-18 days a range of 12-25 days.
- Nonspecific prodromal symptoms develop including low-grade fever which may last 3 to 4 days, myalgia, anorexia, malaise, and headache.
- Several days after onset of prodrome, one or both of the parotid salivary glands begin to swell (parotitis).
- Swelling is first visible in front of the lower part of the ear. It then extends downward and forward as fluid builds up in the skin and soft tissue of the face and neck.
- Inflammation usually peaks in 1 to 3 days and then subsides during the next week.
- Swollen tissue pushes the angle of the ear up and out. As swelling worsens, the angle of the jawbone below the ear is no longer visible.
- One parotid may swell before the other, and in 25% of patients, only one side swells.
- Other salivary glands (submandibular and sublingual) under the floor of the mouth also may swell but do so less frequently (10%).
- Parotitis, lasts at least 2 days, but may persist longer than 10 days.
- Mumps infection may present only with nonspecific or primarily respiratory symptoms, or may be asymptomatic.[1]
Complications
- Symptoms in teenagers and adults may be more severe.
- Complications are relatively rare but may occur in asymptomatic patients and are more common in people who have reached puberty.
- The most common complication is orchitis in post-pubertal males.[1]
- Occurs in approximately 20% of cases in this population
- Orchitis is typically unilateral and testicular atrophy may occur
- Infertility or subfertility is rare but may occur[2] [3] [4]
- Oophoritis and/or mastitis in approximately 5% of post-pubertal females
- Unilateral or less common bilateral transient sensorineural hearing loss - permanent deafness has occurred but is rare[7]
- Meningitis
- Encephalitis
- Spontaneous abortion in about 27% of cases during the first trimester of pregnancy
- Pancreatitis in about 5% of cases[8]
Prognosis
The disease is self-limiting, and the prognosis is generally good, even if other organs are involved. After the illness, life-long immunity to mumps generally occurs. Sterility in men secondary to testicular involvement and death are very rare occurrences.
Resources
References
- ↑ 1.0 1.1 Mumps. Centers for Disease Control and Prevention (May 29, 2015). http://www.cdc.gov/mumps/index.html Accessed March 09, 2016.
- ↑ Preveden T, Jovanovic J, Ristic D (1996). "Fertility in men after mumps infection without manifestations of orchitis". Med Pregl. 49 (3–4): 99–102. PMID 8692089.
- ↑ Shakhov EV, Krupin VN (1990). "The clinico-statistical characteristics of the testicular generative function in male subfertility following mumps". Urol Nefrol (Mosk) (2): 46–50. PMID 2368216.
- ↑ Tsvetkov D (1990). "Spermatological disorders in patients with postmumps orchitis". Akush Ginekol (Sofiia). 29 (6): 46–9. PMID 2100952.
- ↑ Galazka AM, Robertson SE, Kraigher A (1999). "Mumps and mumps vaccine: a global review". Bull World Health Organ. 77 (1): 3–14. PMC 2557572. PMID 10063655.
- ↑ Gupta, R. K (2005). "Mumps and the UK epidemic 2005". BMJ. 330 (7500): 1132–1135. doi:10.1136/bmj.330.7500.1132. ISSN 0959-8138.
- ↑ Hashimoto H, Fujioka M, Kinumaki H, Kinki Ambulatory Pediatrics Study Group (2009). "An office-based prospective study of deafness in mumps". Pediatr Infect Dis J. 28 (3): 173–5. doi:10.1097/INF.0b013e31818a8ca8. PMID 19209100.
- ↑ Nussinovitch M, Volovitz B, Varsano I (1995). "Complications of mumps requiring hospitalization in children". Eur J Pediatr. 154 (9): 732–4. PMID 8582424.