Case history
Case history
A 20-year-old university student with no significant past medical history presents to her doctor with the complaint of painful bilateral swelling near her jaw and cheek. She describes an "earache" and says it is difficult to eat, swallow, and talk. She remembers a low-grade fever and headache several days before the onset of swelling. She had one dose of MMR vaccine as a child.
Other presentations
Mumps infection is asymptomatic in 15% to 20% of cases.[3] Orchitis is the most common symptomatic complication of mumps, occurring in 15% to 30% of post-pubertal males with mumps.[2] Oophoritis is observed in 5% of post-pubertal females, with mastitis also reported.[2]
Aseptic meningitis is the most frequent extra-salivary complication, although often asymptomatic. Pleocytosis of the cerebrospinal fluid can manifest in up to half of all people with symptomatic mumps, but true symptoms of meningeal irritation occur in only 5% to 25% of people. Aseptic meningitis occurs 3 times more frequently in males than females and can occur before, during, or after an episode of parotitis.[4] In some series, up to 50% of people developed mumps meningitis in the absence of parotitis.[5]
Other less common CNS presentations of mumps infection include encephalitis (seen in approximately 0.1% of people with mumps), deafness, cerebellar ataxia, facial palsy, transverse myelitis, and Guillain-Barre syndrome.[6] Pancreatitis occurs in approximately 4% of mumps infections, usually with a relatively mild course.[2]
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