Nejm 1968;279:1357

Cause:Mumps virus, a paramyxovirus

Pathophys:A parotitis

Common; all susceptible exposed patients get neutralizing antibody, 60% get sx

Sx:Nausea and vomiting, fever, pain, and swelling in front of ear and at jaw angle

Si: Parotid enlarged (9/13), unilateral in 15%; ear pushed out, jaw angle obliterated; r/o influenza et al, which can also cause parotitis (Nejm 1977;296:1391). Opsoclonus (dancing nystagmus) and small pupils; fever; aseptic meningitis, 25% have CSF cells, usually benign, can have without parotitis

Pancreatitis, often; meningoencephalitis; orchitis in adult; arthritis, large joint, asymmetric; pneumonia; diabetes induction

Lab:

Chem:Amylase elevated

CSF:Cells in 25%; glucose diminished, protein increased for a long time, often (Nejm 1969;280:855)

Serol:Antibody titers elevated, reliable index of immunity; skin test not helpful

Rx:Isolation of patients of little value since spreads before sx. Active immunization with live virus gives lifelong immunity (Ann IM 1983;98:192)