Specific clinical symptoms
Diagnosis of mumps infection begins with the identification of characteristic local changes.
- Mouritsen's sign: edema and hyperemia of Stensen's duct orifice (the excretory duct of the parotid salivary gland). The orifice may be surrounded by an inflammatory border. When massaging the gland, turbid fluid is sometimes secreted from the duct.
- Filatov's sign: tenderness upon palpation in the retroauricular and preauricular areas.
- Xerostomia: pronounced dryness of the oral mucosa and tongue.
- Gland changes: doughy, moderately to severely painful swelling in the mastoid processes or mandibular angles areas. The skin over the swelling is usually unchanged (no erythema), with no fluctuation. Edema may spread to the mid-neck.
Atypical and combined forms
Mumps infection is not always limited to salivary gland involvement. The diagnosis cannot be ruled out even in the absence of parotitis, as the disease may manifest as isolated involvement of other organs:
- Central nervous system (serous meningitis): manifests with progressive headache, dizziness, vomiting, photophobia (photophobia), hyperacusis (hyperacusis), and the appearance of meningeal signs (nuchal rigidity). Requires hospitalization in a boxed ward.
- Pancreas (acute pancreatitis): deterioration of condition, fever, intense girdle abdominal pain, repeated vomiting, and loose stools.
- Reproductive system (orchiepididymitis): sharp pain in the scrotum (especially when walking), edema, enlargement of the testis, and skin hyperemia. A formidable complication is decreased fertility up to sterility (especially with a bilateral process).
Laboratory and instrumental diagnostics
To verify the diagnosis and assess the involvement of other organs, a set of studies is used:
- Serological diagnostics: detection of specific anti-mumps immunoglobulins of IgM and IgG classes dynamically using CFtest or ELISA reactions.
- Complete blood count (CBC): a typical picture is characterized by normocytosis or moderate leukocytosis without a significant left shift. Pronounced leukocytosis with a sharp left shift contradicts the diagnosis.
- Biochemical studies: determination of serum amylase and urine diastase activity when pancreatitis is suspected.
- Lumbar puncture: in the presence of meningeal symptoms (serous cerebrospinal fluid is characteristic).
- Abdominal ultrasound: to assess the condition of the pancreas.
Differential diagnosis
The clinical picture of mumps must be differentiated from a number of other pathologies:
- Infectious mononucleosis: unlike it, mumps lacks pronounced polyadenopathy, catarrhal phenomena, tonsillitis (plaque on the tonsils), and atypical mononuclear cells in the blood.
- Toxic oropharyngeal diphtheria: in diphtheria, dense plaques are present on the tonsils, and swallowing is impaired. In mumps, the oropharyngeal mucosa is intact.
- Surgical infection (phlegmon, erysipelas): erysipelas is characterized by bright red erythema with clear uneven edges, a burning sensation, and sharp neutrophilic leukocytosis with a left shift (up to 25% band neutrophils), which is absolutely untypical for viral parotitis.
Briefly: answers to topical questions
What detailed cerebrospinal fluid characteristics are typical for meningitis in mumps?
Mumps meningitis is characterized by serous cerebrospinal fluid with decreased glucose levels. The composition of the cerebrospinal fluid includes:
- Pleocytosis — moderately pronounced lymphocytic;
- Protein — increased level;
- Glucose — decreased level.
What is the incubation period for mumps?
The incubation period for mumps ranges from 11 to 23 days, but most commonly lasts 14–20 or 15–19 days.
What methods of specific prevention of mumps exist?
Specific prevention of mumps is carried out by vaccination with a live vaccine. Prevention methods:
- Routine vaccination — administered at 12 months of age (subcutaneously), revaccination at 6 years;
- Emergency prophylaxis — indicated for unvaccinated individuals who have not had mumps infection, the vaccine is administered no later than 72 hours after contact with an infected person.
Live dry culture mumps monovaccine or combined vaccines (measles-mumps, measles-mumps-rubella) are used.
Mumps is not just about cheeks. Look for GLAND involvement (salivary, pancreas, testes) and MENINGES (serous meningitis).
Class and exam questions
Can the diagnosis of mumps infection be ruled out if the parotid glands are not enlarged?
No. The disease can run an atypical course, manifesting as isolated CNS involvement (meningitis) or other glandular organs without classical parotitis.
What changes in the complete blood count contradict the diagnosis of mumps infection?
Pronounced leukocytosis (e.g., 15–18 thousand) with a sharp left shift in the leukocyte formula (high percentage of band neutrophils) indicates a bacterial process rather than viral mumps.
What is checked in the presence of symptoms of mumps pancreatitis?
Abdominal ultrasound is prescribed, and serum amylase activity and urine diastase levels are determined.
What else to study on this topic
- Pathogenesis and clinical presentation of mumps meningitis
- Features of differential diagnosis with infectious mononucleosis
- Management tactics and treatment of mumps orchiepididymitis
- Justification of treatment tactics in pancreatic involvement
Master the complete topic in the «Infectious Diseases» course
This is a summary. The course covers everything tested in classes and exams.
- Complete guidelines on "Diagnosis of Mumps" and 3,312 other pages of the subject
- Assignments and quizzes after every topic — just like in a colloquium
- AI tutor answers questions on the topic anytime
- 41 video lessons on the subject
Other topics in the "Respiratory Infections" section
The entire "Respiratory Infections" sectionPrepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.