Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 32-02: Major Vaccine-Preventable Viral Infections + Key Features Download Section PDF Listen +++ ++ Spread by respiratory droplets Produces inflammation of salivary glands (eg, parotitis) and occasionally orchitis and meningitis + Clinical Findings Download Section PDF Listen +++ ++ Parotid tenderness and overlying facial edema common Fever and malaise variable Orchitis 7–10 days after parotitis; rarely leads to sterility Meningitis third most common manifestation Other manifestations include Pancreatitis Oophoritis Thyroiditis Neuritis Hepatitis Myocarditis Encephalitis + Diagnosis Download Section PDF Listen +++ ++ Symptom onset occurs 12–25 days postexposure Painful, swollen parotid and other salivary glands Orchitis, pancreatitis, or meningitis in setting of parotitis is usually diagnostic Lymphocytosis and elevated serum amylase are common Serologic testing may be useful but not commonly done Nucleic acid amplification techniques, such as real-time reverse transcriptase polymerase chain reaction (RT-PCR), are more sensitive than viral cultures Serum neutralization titers best for determining immunity + Treatment Download Section PDF Listen +++ ++ Supportive measures Febrile patients should be kept on bed rest and isolated while there is parotid swelling Orchitis Can be managed with scrotal support and ice packs Incision of the tunica may be necessary in severe cases Pain can be relieved with opioids, or by injecting the spermatic cord at the external inguinal ring with 10–20 mL of 1% procaine solution Interferon alpha-2b may be useful in preventing testicular atrophy Prevention: mumps live virus vaccine is safe and highly effective (Table 30–7) Vaccine should be avoided in pregnant women and immunocompromised persons Vaccine probably safe in adults with asymptomatic HIV infection