Mumps

Epidemic parotitis

Mumps is a contagious disease that leads to painful swelling of the salivary glands. The salivary glands produce saliva, a liquid that moistens food and helps you chew and swallow.

Causes, incidence, and risk factors

The mumps are caused by a virus. The virus is spread from person-to-person by respiratory droplets (for example, when you sneeze) or by direct contact with items that have been contaminated with infected saliva. Mumps most commonly occurs in children ages 2 - 12 who have not been vaccinated against the disease. However, the infection can occur at any age. The time between being exposed to the virus and getting sick (incubation period) is usually 12 - 24 days. Mumps may also infect the:

Central nervous system Pancreas Testes

Symptoms

Face pain Fever Headache Sore throat Swelling of the parotid glands (the largest salivary glands, located between the ear and the jaw) Swelling of the temples or jaw (temporomandibular area)

Other symptoms of this disease that can occur in males:

Testicle lump Testicle pain Scrotal swelling

Signs and tests

A physical examination confirms the presence of the swollen glands. No testing is usually required.

Treatment
There is no specific treatment for mumps. Ice or heat packs applied to the neck area and acetaminophen (Tylenol) may help relieve pain. Do not give aspirin to children with a viral illness because of the risk of Reye syndrome. You can also relieve symptoms with:

Extra fluids Soft foods Warm salt water gargles

Expectations (prognosis)
Patients usually do well, even if other organs are involved. After the illness, the patient has a lifelong immunity to the mumps.

Complications
Infection of other organs may occur, including orchitis. Go to the emergency room or call the local emergency number (such as 911) if convulsions occur.

Prevention
MMR immunization (vaccine) protects against measles, mumps, and rubella. It should be given to children 12 - 15 months old. The vaccine is given again between ages 4 - 6, or between ages 11 - 12, if it wasn't given before. Recent outbreaks of the mumps have reinforced the importance of having all children vaccinated.

Orchitis
Epididymo-orchitis; Testis infection

Last reviewed: September 3, 2010. Orchitis is swelling (inflammation) of one or both of the testicles.

Causes, incidence, and risk factors

Orchitis may be caused by an infection from many different types of bacteria and viruses.

The most common virus that causes orchitis is mumps. It most often occurs in boys after puberty. Orchitis usually develops 4 - 6 days after the mumps begins. Because of childhood vaccinations, mumps is now rare in the United States. Orchitis may also occur along with infections of the prostate or epididymis. Orchitis may be caused by sexually transmitted diseases (STD), such as gonorrhea or chlamydia. The rate of sexually transmitted orchitis or epididymitis is higher in men ages 19 - 35. Risk factors for sexually transmitted orchitis include:

High-risk sexual behaviors Multiple sexual partners Personal history of gonorrhea or another STD Sexual partner with a diagnosed STD

Risk factors for orchitis not due to an STD include:

Being older than age 45 Long-term use of a Foley catheter Not being vaccinated against the mumps Problems of the urinary tract that occurred at birth (congenital) Regular urinary tract infections Surgery of the urinary tract (genitourinary surgery)

Symptoms

Blood in the semen Discharge from penis Fever Groin pain Pain with intercourse or ejaculation Pain with urination (dysuria) Scrotal swelling Tender, swollen groin area on affected side Tender, swollen, heavy feeling in the testicle Testicle pain that is made worse by a bowel movement or straining

Signs and tests

A physical examination may show:

Enlarged or tender prostate gland Tender and enlarged lymph nodes in the groin (inguinal) area on the affected side Tender and enlarged testicle on the affected side

Tests may include:

Complete blood count (CBC) Testicular ultrasound Tests to screen for chlamydia and gonorrhea (urethral smear) Urinalysis Urine culture (clean catch) -- may need several samples, including initial stream, midstream, and after prostate massage

Treatment
Treatments may include:

Antibiotics -- if the infection is caused by bacteria (in the case of gonorrhea or chlamydia, sexual partners must also be treated) Anti-inflammatory medications Pain medications Bed rest with the scrotum elevated and ice packs applied to the area

Expectations (prognosis)
Getting the right diagnosis and treatment for orchitis caused by bacteria can usually preserve the normal testicle function. If the testicle does not completely return to normal after treatment, further testing to rule out testicular cancer should be done. Mumps orchitis cannot be treated, and the outcome can vary. Men who have had mumps orchitis can become sterile.

Complications
Some boys who get orchitis caused by mumps will have shrinking of the testicles (testicular atrophy). Orchitis may also cause infertility. Other potential complications include:

Chronic epididymitis Death of testicle tissue (testicular infarction) Fistula on the skin of the scrotum (cutaneous scrotal fistula) Scrotal abscess

Acute pain in the scrotum or testicles can be caused by twisting of the testicular blood vessels (torsion), which is a surgical emergency. If you have sudden pain in the scrotum or testicles, get immediate medical attention.