Tests
1st tests to order
salivary mumps IgM
Test
The pattern of response and accuracy of salivary IgM is very similar to that for serum IgM.[34]
Result
positive or negative for mumps
reverse transcriptase PCR
Test
Testing is done directly on the clinical specimen, preferably saliva. Can confirm the diagnosis, identify the viral strain, and help with epidemiological studies.[2] It is not the preferred test for virus in the urine. According to the US guidelines, the recent laboratory support update for Vaccine Preventable Diseases (VPD) surveillance underscores the scarcity of mumps specimens submitted to VPD-Reference Centers (RCs) and Centers for Disease Control and Prevention (CDC) for genotyping, emphasizing the importance of enhanced molecular characterization of circulating mumps virus whenever feasible. The CDC presently accepts only buccal swabs. Advice from local laboratory/VPD-RCs should be sought to determine acceptable sample types.[29]
Result
positive
Tests to consider
CBC and differential
Test
Useful if further confirmation of diagnosis is needed.
Result
possible leukocytosis in mumps meningitis, orchitis, or pancreatitis
serum mumps IgM
Test
Positive IgM confirms the diagnosis. A negative test does not rule out mumps infection.[32]
Should be performed no earlier than 3 days following the onset of clinical symptoms, and it has been suggested that the ideal time for IgM testing is 7-10 days after the onset of symptoms.[31]
Result
positive or negative for mumps
serum mumps IgG
Test
A 4-fold rise in IgG titers between acute and convalescent titers confirms the diagnosis. A negative test does not rule out mumps infection.[32]
The acute titer should be drawn approximately 4 days after the onset of original symptoms. The convalescent titer should be drawn 2-3 weeks after the onset of symptoms.
Result
positive or negative for mumps
serum amylase
Result
elevated
viral culture (CSF, saliva, or urine)
Test
Viral culture from CSF, saliva, or urine confirms the diagnosis.[41] Useful if further confirmation of diagnosis is needed.
Result
positive
lumbar puncture
Test
If neurologic complications are suspected (e.g., severe headache, clouding of consciousness, focal neurologic signs), CSF analysis can be used to help with diagnosis.
Result
CSF cell count: lymphocytosis in mumps meningitis and encephalitis; possible pleocytosis; CSF pressure, glucose: generally normal; protein: generally normal but may be elevated
CT head
Test
Used as an initial test if there are focal neurologic symptoms, including sensory or motor abnormalities, vision changes, or cognitive abnormalities.
Result
normal in uncomplicated disease, but focal lesions may be present; excludes other pathology
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