What are the common complications of mumps. How does mumps affect the testicles and ovaries. What rare complications can occur with mumps. How is mumps-related orchitis treated. Is mumps dangerous during pregnancy.

Common Complications of Mumps: From Swollen Testicles to Viral Meningitis

Mumps, while often considered a childhood illness, can lead to several complications, especially in adults. Understanding these complications is crucial for proper management and treatment.

Orchitis: Swelling and Pain in the Testicles

Orchitis, the inflammation of one or both testicles, is a common complication of mumps in post-pubertal males. How frequently does this occur? Up to 1 in 3 males who contract mumps after puberty may experience orchitis. The symptoms typically manifest 4 to 8 days after the initial swelling of the parotid glands, though in some cases, it may appear up to 6 weeks later.

• Sudden swelling, usually affecting only one testicle
• Warmth and tenderness in the affected area
• Pain, which can be severe

How is mumps-related orchitis treated? Treatment primarily focuses on symptom management:

1. Over-the-counter painkillers like paracetamol or ibuprofen
2. Prescription of stronger painkillers for severe cases
3. Application of cold or warm compresses
4. Wearing supportive underwear to reduce discomfort

Can orchitis lead to long-term complications? While just under half of affected males may notice some testicular shrinkage, and about 1 in 10 may experience a temporary decrease in sperm count, infertility due to mumps orchitis is extremely rare.

Oophoritis: Swelling of the Ovaries

Females are not exempt from reproductive complications. About 1 in 15 females who contract mumps after puberty may experience oophoritis, or swelling of the ovaries. What are the symptoms of oophoritis?

• Lower abdominal pain
• Elevated body temperature
• Nausea and vomiting

Fortunately, these symptoms typically resolve as the body fights off the mumps infection.

Viral Meningitis: When Mumps Affects the Brain

Viral meningitis occurs when the mumps virus spreads to the protective layer surrounding the brain. How common is this complication? It can affect up to 1 in 4 mumps cases. Unlike its bacterial counterpart, viral meningitis associated with mumps is generally milder and less dangerous.

Symptoms of mumps-related viral meningitis include:

• Sensitivity to light
• Neck stiffness
• Headaches

These symptoms usually resolve within two weeks.

Pancreatitis: Inflammation of the Pancreas

Approximately 1 in 25 mumps cases may lead to acute pancreatitis, a short-term inflammation of the pancreas. What are the signs of mumps-related pancreatitis?

• Sudden pain in the center of the abdomen
• Nausea and vomiting
• Diarrhea
• Loss of appetite
• Elevated body temperature
• Abdominal tenderness
• In some cases, jaundice (yellowing of the eyes and skin)

While usually mild, some cases may require hospitalization to support bodily functions until the pancreas recovers.

Rare but Serious Complications: When Mumps Becomes More Than Just Swollen Glands

While most mumps cases resolve without significant issues, some rare complications can occur that require immediate medical attention.

Encephalitis: When Mumps Affects the Brain

Encephalitis, or inflammation of the brain itself, is a rare but potentially life-threatening complication of mumps. How often does this occur? It’s estimated to affect about 1 in 1,000 mumps cases. Due to its severity, encephalitis requires immediate hospitalization and intensive care.

Hearing Loss: Temporary and Permanent

Hearing impairment is another potential complication of mumps. How common is hearing loss in mumps patients?

• About 1 in 25 people with mumps experience temporary hearing loss
• Permanent hearing loss is much rarer, occurring in approximately 1 in 20,000 cases

While the risk of permanent hearing damage is low, any changes in hearing during or after a mumps infection should be reported to a healthcare provider promptly.

Mumps and Pregnancy: Separating Fact from Fiction

Historically, there were concerns about the impact of mumps on pregnancy. However, current evidence suggests these fears may have been overstated.

Does mumps increase the risk of miscarriage? While it was previously thought that contracting mumps during pregnancy increased the risk of miscarriage, recent studies have found little evidence to support this claim.

Nevertheless, as a precautionary measure, pregnant women are advised to avoid close contact with individuals known to have an active mumps infection. This recommendation extends to avoiding contact with people with any type of active infection during pregnancy.

What should a pregnant woman do if exposed to mumps? If you’re pregnant and believe you’ve been exposed to someone with mumps, especially if you haven’t been vaccinated, it’s important to contact your healthcare provider or midwife for advice as soon as possible.

Vaccination: The Key to Preventing Mumps and Its Complications

Given the potential complications associated with mumps, prevention through vaccination is crucial. The mumps vaccine is typically administered as part of the MMR (Measles, Mumps, Rubella) vaccine.

Effectiveness of the Mumps Vaccine

How effective is the mumps vaccine? The effectiveness of the mumps vaccine can vary:

• One dose of the MMR vaccine is about 78% effective against mumps
• Two doses increase the effectiveness to about 88%

While not 100% effective, vaccination significantly reduces the risk of contracting mumps and experiencing its potential complications.

Vaccination Schedule

When should individuals receive the mumps vaccine? The typical vaccination schedule includes:

1. First dose: Between 12-15 months of age
2. Second dose: Between 4-6 years of age

Adults who haven’t been vaccinated or have only received one dose should consult their healthcare provider about getting fully vaccinated.

Diagnosis and Treatment of Mumps: Beyond the Swollen Cheeks

While the characteristic swollen cheeks often associated with mumps can be a clear indicator, proper diagnosis and treatment are essential, especially when complications arise.

Diagnosing Mumps

How is mumps diagnosed? Diagnosis typically involves:

• Physical examination
• Review of symptoms and medical history
• Blood tests to detect mumps antibodies
• Viral culture or PCR test using a sample from the cheek, throat, or urine

Treatment Approaches

What is the primary treatment for mumps? As mumps is a viral infection, treatment mainly focuses on managing symptoms and preventing complications. This may include:

• Rest and hydration
• Over-the-counter pain relievers
• Cold or warm compresses for swollen glands
• Soft foods that don’t require much chewing

For more severe cases or when complications occur, hospitalization may be necessary to provide supportive care and monitor the patient’s condition closely.

Long-Term Effects of Mumps: What to Expect After Recovery

While most people recover fully from mumps without lasting effects, some individuals may experience long-term consequences, particularly if they’ve suffered from severe complications.

Fertility Concerns

Can mumps affect fertility? While rare, mumps orchitis can potentially impact male fertility:

• About 50% of males with mumps-related orchitis may experience some testicular atrophy
• Approximately 10% may have a decreased sperm count
• However, complete infertility due to mumps is extremely rare

For females, while oophoritis can occur, there’s little evidence to suggest it leads to long-term fertility issues.

Neurological Effects

In rare cases where mumps leads to encephalitis or severe meningitis, there may be long-term neurological effects. These can include:

• Cognitive impairments
• Motor function difficulties
• Behavioral changes

However, it’s important to note that such severe complications are extremely rare, especially in vaccinated populations.

Global Impact of Mumps: A Public Health Perspective

Despite widespread vaccination programs, mumps continues to be a public health concern in many parts of the world.

Incidence and Outbreaks

How common is mumps globally? The incidence of mumps varies greatly:

• In countries with high vaccination rates, large outbreaks are rare but can occur, often in close-contact settings like colleges
• In areas with lower vaccination rates, mumps remains more common and can lead to larger outbreaks

Economic Impact

What is the economic burden of mumps? The cost of mumps extends beyond individual health:

• Direct medical costs for treatment and hospitalization
• Indirect costs due to lost productivity and missed work or school days
• Costs associated with outbreak control measures

These factors underscore the importance of maintaining high vaccination rates to prevent outbreaks and their associated costs.

Ongoing Research and Development

What advancements are being made in mumps prevention and treatment? Ongoing research focuses on:

• Developing more effective vaccines
• Understanding why outbreaks occur in vaccinated populations
• Improving diagnostic tests for quicker, more accurate detection
• Investigating potential antiviral treatments for severe cases

These efforts aim to further reduce the global burden of mumps and its complications.

Mumps – Complications – NHS

There are several problems that often occur with mumps. These can be worrying, but they’re rarely serious and usually improve as the infection passes.

Common complications

Swollen testicle

Pain and swelling of the testicle (orchitis) affects up to 1 in 3 males who get mumps after puberty. The swelling is usually sudden and affects only one testicle. The testicle may also feel warm and tender.

In affected boys and men, swelling of the testicle normally begins 4 to 8 days after the swelling of the parotid gland. Occasionally, swelling can occur up to 6 weeks after the swelling of the glands.

Any testicle pain can be eased using painkillers such as paracetamol or ibuprofen you buy from the pharmacy or supermarket. If the pain is particularly severe, contact your GP, who may prescribe you a stronger painkiller.

Applying cold or warm compresses to your testicle and wearing supportive underwear may also reduce any pain.

Just under half of all males who get mumps-related orchitis notice some shrinkage of their testicles and an estimated 1 in 10 men experience a drop in their sperm count (the amount of healthy sperm their body can produce). However, this is very rarely large enough to cause infertility.

Swollen ovaries

About 1 in 15 females who get mumps after puberty experience swelling of the ovaries (oophoritis), which can cause:

• lower abdominal pain
• high temperature
• being sick

The symptoms of oophoritis usually pass once the body has fought off the underlying mumps infection.

Viral meningitis

Viral meningitis can occur if the mumps virus spreads into the outer protective layer of the brain (the meninges). It occurs in up to 1 in 4 cases of mumps.

Unlike bacterial meningitis, which is regarded as a potentially life-threatening medical emergency, viral meningitis causes milder, flu-like symptoms, and the risk of serious complications is low.

Sensitivity to light, neck stiffness and headaches are common symptoms of viral meningitis. These usually pass within 14 days.

Pancreatitis

About 1 in 25 cases of mumps lead to short-term inflammation of the pancreas (acute pancreatitis). The most common symptom is sudden pain in the centre of your belly.

Other symptoms of acute pancreatitis can include:

• feeling or being sick
• diarrhoea
• loss of appetite
• high temperature
• tenderness of the belly
• less commonly, yellowing of the whites of the eyes and the skin (jaundice), although this may be less noticeable on black or brown skin

Although pancreatitis associated with mumps is usually mild, you may be admitted to hospital so your body functions can be supported until your pancreas recovers.

Rare complications of mumps

Rare but potentially serious complications of mumps include an infection of the brain itself, known as encephalitis. This is thought to occur in around 1 in 1,000 cases of mumps. Encephalitis is a potentially fatal condition that requires admission to a hospital intensive care unit.

About 1 in 25 people with mumps experience some temporary hearing loss, but permanent loss of hearing is rare. It’s estimated this occurs in around 1 in 20,000 cases of mumps.

Mumps and pregnancy

In the past it was thought developing mumps during pregnancy increased the risk of miscarriage, but there’s little evidence to support this.

But, as a general precaution it’s recommended pregnant women avoid close contact with people known to have an active mumps infection (or any other type of infection).

If you’re pregnant and you think you’ve come into contact with someone with mumps but you haven’t been vaccinated, contact your GP or midwife for advice.

Page last reviewed: 24 September 2021
Next review due: 24 September 2024

Mumps Orchitis: Clinical Aspects and Mechanisms

1.
Hviid A, Rubin S, Mühlemann K. Mumps. Lancet (2008) 371:932–44.   10.1016/s0140-6736(08)60419-5
[PubMed] [CrossRef] [Google Scholar]

2.
Masarani M, Wazait H, Dinneen M. Mumps orchitis. J R Soc Med (2006) 99:573–5.   10.1258/jrsm.99.11.573
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

3.
Ternavasio-de la Vega HG, Boronat M, Ojeda A, Garcia-Delgado Y, Angel-Moreno A, Carranza-Rodriguez C, et al.. Mumps orchitis in the post-vaccine era (1967-2009): a single-center series of 67 patients and review of clinical outcome and trends. Med (Baltimore) (2010) 89:96–116.   10.1097/MD.0b013e3181d63191
[PubMed] [CrossRef] [Google Scholar]

4.
Rozina EE, Hilgenfeldt M. Comparative study on the neurovirulence of different vaccine strains of parotitis virus in monkeys. Acta Virol (1985) 29:225–30. [PubMed] [Google Scholar]

5.
McCarthy M, Jubelt B, Fay DB, Johnson RT. Comparative studies of five strains of mumps virus in vitro and in neonatal hamsters: evaluation of growth, cytopathogenicity, and neurovirulence. J Med Virol (1980) 5:1–15.   10.1002/jmv.1890050102
[PubMed] [CrossRef] [Google Scholar]

6.
Kilham L, Margolis G. Induction of congenital hydrocephalus in hamsters with attenuated and natural strains of mumps virus. J Infect Dis (1975) 132:462–6.   10.1093/infdis/132.4.462
[PubMed] [CrossRef] [Google Scholar]

7.
Parker L, Gilliland SM, Minor P, Schepelmann S. Assessment of the ferret as an in vivo model for mumps virus infection. J Gen Virol (2013) 94:1200–5.   10.1099/vir.0.052449-0
[PubMed] [CrossRef] [Google Scholar]

8.
Xu P, Huang Z, Gao X, Michel FJ, Hirsch G, Hogan RJ, et al.. Infection of mice, ferrets, and rhesus macaques with a clinical mumps virus isolate. J Virol (2013) 87:8158–68.   10.1128/JVI.01028-13
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

9.
Wu H, Zhao X, Wang F, Jiang Q, Shi L, Gong M, et al.. Mouse Testicular Cell Type-Specific Antiviral Response against Mumps Virus Replication. Front Immunol (2017) 8:117.   10.3389/fimmu.2017.00117
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

10.
Jiang Q, Wang F, Shi L, Zhao X, Gong M, Liu W, et al.. C-X-C motif chemokine ligand 10 produced by mouse Sertoli cells in response to mumps virus infection induces male germ cell apoptosis. Cell Death Dis (2017) 8:e3146.   10.1038/cddis.2017.560
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

11.
Wu H, Shi L, Wang Q, Cheng L, Zhao X, Chen Q, et al.. Mumps virus-induced innate immune responses in mouse Sertoli and Leydig cells. Sci Rep (2016) 6:19507.   10.1038/srep19507
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

12.
Rubin S, Eckhaus M, Rennick LJ, Bamford CG, Duprex WP. Molecular biology, pathogenesis and pathology of mumps virus. J Pathol (2015) 235:242–52.   10.1002/path.4445
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

13.
Jin L, Orvell C, Myers R, Rota PA, Nakayama T, Forcic D, et al.. Genomic diversity of mumps virus and global distribution of the 12 genotypes. Rev Med Virol (2015) 25:85–101.   10.1002/rmv.1819
[PubMed] [CrossRef] [Google Scholar]

14.
Johansson B, Tecle T, Orvell C. Proposed criteria for classification of new genotypes of mumps virus. Scand J Infect Dis (2002) 34:355–7.   10.1080/00365540110080043
[PubMed] [CrossRef] [Google Scholar]

15.
Galazka AM, Robertson SE, Kraigher A. Mumps and mumps vaccine: a global review. Bull World Health Organ (1999) 77:3–14. 10.1007/bf02727158
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

16.
Edmunds WJ, Gay NJ, Kretzschmar M, Pebody RG, Wachmann H. Network EPES-e. The pre-vaccination epidemiology of measles, mumps and rubella in Europe: implications for modelling studies. Epidemiol Infect (2000) 125:635–50.   10.1017/s0950268800004672
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

17.
Vandermeulen C, Roelants M, Vermoere M, Roseeuw K, Goubau P, Hoppenbrouwers K. Outbreak of mumps in a vaccinated child population: a question of vaccine failure? Vaccine (2004) 22:2713–6.   10.1016/j.vaccine.2004.02.001
[PubMed] [CrossRef] [Google Scholar]

18.
Westphal DW, Eastwood A, Levy A, Davies J, Huppatz C, Gilles M, et al.. A protracted mumps outbreak in Western Australia despite high vaccine coverage: a population-based surveillance study. Lancet Infect Diseases (2019) 19:177–84.   10.1016/s1473-3099(18)30498-5
[PubMed] [CrossRef] [Google Scholar]

19.
Qin W, Wang Y, Yang T, Xu XK, Meng XM, Zhao CJ, et al.. Outbreak of mumps in a student population with high vaccination coverage in China: time for two-dose vaccination. Hum Vaccin Immunother (2019) 15:2106–11.   10.1080/21645515.2019.1581526
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

20.
Ma R, Lu L, Zhou T, Pan J, Chen M, Pang X. Mumps disease in Beijing in the era of two-dose vaccination policy, 2005-2016. Vaccine (2018) 36:2589–95.   10.1016/j.vaccine.2018.03.074
[PubMed] [CrossRef] [Google Scholar]

21.
Beleni AI, Borgmann S. Mumps in the Vaccination Age: Global Epidemiology and the Situation in Germany. Int J Environ Res Public Health (2018) 15:1618.   10.3390/ijerph25081618
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

22.
Willocks LJ, Guerendiain D, Austin HI, Morrison KE, Cameron RL, Templeton KE, et al.. An outbreak of mumps with genetic strain variation in a highly vaccinated student population in Scotland. Epidemiol Infect (2017) 145:3219–25.   10.1017/S0950268817002102
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

23.
Patel LN, Arciuolo RJ, Fu J, Giancotti FR, Zucker JR, Rakeman JL, et al.. Mumps Outbreak Among a Highly Vaccinated University Community-New York City, January-April 2014. Clin Infect Dis (2017) 64:408–12.   10.1093/cid/ciw762
[PubMed] [CrossRef] [Google Scholar]

24.
Havlickova M, Limberkova R, Smiskova D, Herrmannova K, Jirincova H, Novakova L, et al.. Mumps in the Czech Republic in 2013: Clinical Characteristics, Mumps Virus Genotyping, and Epidemiological Links. Cent Eur J Public Health (2016) 24:22–8.   10.21101/cejph.a4512
[PubMed] [CrossRef] [Google Scholar]

25.
Nedeljkovic J, Kovacevic-Jovanovic V, Milosevic V, Seguljev Z, Petrovic V, Muller CP, et al.. A Mumps Outbreak in Vojvodina, Serbia, in 2012 Underlines the Need for Additional Vaccination Opportunities for Young Adults. PloS One (2015) 10:e0139815.   10.1371/journal.pone.0139815
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

26.
Sane J, Gouma S, Koopmans M, de Melker H, Swaan C, van Binnendijk R, et al.. Epidemic of mumps among vaccinated persons, The Netherlands, 2009-2012. Emerg Infect Dis (2014) 20:643–8.   10.3201/eid2004.131681
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

27.
Gilliland SM, Jenkins A, Parker L, Somdach N, Pattamadilok S, Incomserb P, et al. . Vaccine-related mumps infections in Thailand and the identification of a novel mutation in the mumps fusion protein. Biologicals (2013) 41:84–7.   10.1016/j.biologicals.2012.09.007
[PubMed] [CrossRef] [Google Scholar]

28.
Barskey AE, Schulte C, Rosen JB, Handschur EF, Rausch-Phung E, Doll MK, et al.. Mumps outbreak in Orthodox Jewish communities in the United States. N Engl J Med (2012) 367:1704–13.   10.1056/NEJMoa1202865
[PubMed] [CrossRef] [Google Scholar]

29.
Roberts C, Porter-Jones G, Crocker J, Hart J. Mumps outbreak on the island of Anglesey, North Wales, December 2008-January 2009. Euro Surveill (2009) 14:19109.   10.2807/ese.14.05.19109-en
[PubMed] [CrossRef] [Google Scholar]

30.
Cortese MM, Jordan HT, Curns AT, Quinlan PA, Ens KA, Denning PM, et al.. Mumps vaccine performance among university students during a mumps outbreak. Clin Infect Dis (2008) 46:1172–80.   10.1086/529141
[PubMed] [CrossRef] [Google Scholar]

31.
Castilla J, Garcia Cenoz M, Barricarte A, Irisarri F, Nunez-Cordoba JM, Barricarte A. Mumps outbreak in Navarre region, Spain, 2006-2007. Euro Surveill (2007) 12:E070215.070211.   10.2807/esw.12.07.03139-en
[PubMed] [CrossRef] [Google Scholar]

32.
Zheng J, Zhou Y, Wang H, Liang X. The role of the China Experts Advisory Committee on Immunization Program. Vaccine (2010) 28 Suppl 1:A84–7.   10.1016/j.vaccine.2010.02.039
[PubMed] [CrossRef] [Google Scholar]

33.
Davis NF, McGuire BB, Mahon JA, Smyth AE, O’Malley KJ, Fitzpatrick JM. The increasing incidence of mumps orchitis: a comprehensive review. BJU Int (2010) 105:1060–5.   10.1111/j.1464-410X.2009.09148.x
[PubMed] [CrossRef] [Google Scholar]

34.
Centers for Disease Control and Prevention (CDC). Mumps epidemic–Iowa, 2006. MMWR Morb Mortal Wkly Rep (2006) 55:366–8. [PubMed] [Google Scholar]

35.
Tae BS, Ham BK, Kim JH, Park JY, Bae JH. Clinical features of mumps orchitis in vaccinated postpubertal males: a single-center series of 62 patients. Korean J Urol (2012) 53:865–9.   10.4111/kju.2012.53. 12.865
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

36.
A retrospective survey of the complications of mumps. J R Coll Gen Pract (1974) 24:552–6. [PMC free article] [PubMed] [Google Scholar]

37.
Bartak V. Sperm count, morphology and motility after unilateral mumps orchitis. J Reprod Fertil (1973) 32:491–4.   10.1530/jrf.0.0320491
[PubMed] [CrossRef] [Google Scholar]

38.
Clifford V, Wadsley J, Jenner B, Buttery JP. Mumps vaccine associated orchitis: Evidence supporting a potential immune-mediated mechanism. Vaccine (2010) 28:2671–3.   10.1016/j.vaccine.2010.01.007
[PubMed] [CrossRef] [Google Scholar]

39.
Kanda T, Mochida J, Takada S, Hori Y, Yamaguchi K, Takahashi S. Case of mumps orchitis after vaccination. Int J Urol (2014) 21:426–8.   10.1111/iju.12305
[PubMed] [CrossRef] [Google Scholar]

40.
Abdelbaky AM, Channappa DB, Islam S. Unilateral epididymo-orchitis: a rare complication of MMR vaccine. Ann R Coll Surg Engl (2008) 90:336–7.   10. 1308/003588408X285694
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

41.
Suzuki M, Takizawa A, Furuta A, Yanada S, Iwamuro S, Tashiro K. A case of orchitis following vaccination with freeze-dried live attenuated mumps vaccine. Nihon Hinyokika Gakkai Zasshi (2002) 93:577–9.   10.5980/jpnjurol1989.93.577
[PubMed] [CrossRef] [Google Scholar]

42.
Wharton IP, Chaudhry AH, French ME. A case of mumps epididymitis. Lancet (2006) 367:702.   10.1016/S0140-6736(06)68274-3
[PubMed] [CrossRef] [Google Scholar]

43.
Tarantino L, Giorgio A, de Stefano G, Farella N. Echo color Doppler findings in postpubertal mumps epididymo-orchitis. J Ultrasound Med (2001) 20:1189–95.   10.7863/jum.2001.20.11.1189
[PubMed] [CrossRef] [Google Scholar]

44.
Park SJ, Kim HC, Lim JW, Moon SK, Ahn SE. Distribution of Epididymal Involvement in Mumps Epididymo-orchitis. J Ultrasound Med (2015) 34:1083–9.   10.7863/ultra.34.6.1083
[PubMed] [CrossRef] [Google Scholar]

45.
Yang DM, Kim SH, Kim HN, Kang JH, Seo TS, Hwang HY, et al. . Differential diagnosis of focal epididymal lesions with gray scale sonographic, color Doppler sonographic, and clinical features. J Ultrasound Med (2003) 22:135–42; quiz 143-134.   10.7863/jum.2003.22.2.135
[PubMed] [CrossRef] [Google Scholar]

46.
Adamopoulos DA, Lawrence DM, Vassilopoulos P, Contoyiannis PA, Swyer GI. Pituitary-testicular interrelationships in mumps orchitis and other viral infections. Br Med J (1978) 1:1177–80.   10.1136/bmj.1.6121.1177
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

47.
Choi HI, Yang DM, Kim HC, Kim SW, Jeong HS, Moon SK, et al.. Testicular atrophy after mumps orchitis: ultrasonographic findings. Ultrasonography (2020) 39:266–71.   10.14366/usg.19097
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

48.
Basekim CC, Kizilkaya E, Pekkafali Z, Baykal KV, Karsli AF. Mumps epididymo-orchitis: sonography and color Doppler sonographic findings. Abdom Imaging (2000) 25:322–5.   10.1007/s002610000039
[PubMed] [CrossRef] [Google Scholar]

49.
Krause CH, Molyneaux PJ, Ho-Yen DO, McIntyre P, Carman WF, Templeton KE. Comparison of mumps-IgM ELISAs in acute infection. J Clin Virol (2007) 38:153–6.   10.1016/j.jcv.2006.10.010
[PubMed] [CrossRef] [Google Scholar]

50.
Jalal H, Bahadur G, Knowles W, Jin L, Brink N. Mumps epididymo-orchitis with prolonged detection of virus in semen and the development of anti-sperm antibodies. J Med Virol (2004) 73:147–50.   10.1002/jmv.10544
[PubMed] [CrossRef] [Google Scholar]

51.
Casella R, Leibundgut B, Lehmann K, Gasser TC. Mumps orchitis: report of a mini-epidemic. J Urol (1997) 158:2158–61.   10.1016/s0022-5347(01)68186-2
[PubMed] [CrossRef] [Google Scholar]

52.
Erpenbach KH. Systemic treatment with interferon-alpha 2B: an effective method to prevent sterility after bilateral mumps orchitis. J Urol (1991) 146:54–6.   10.1016/s0022-5347(17)37713-3
[PubMed] [CrossRef] [Google Scholar]

53.
Yeniyol CO, Sorguc S, Minareci S, Ayder AR. Role of interferon-alpha-2B in prevention of testicular atrophy with unilateral mumps orchitis. Urology (2000) 55:931–3.   10.1016/s0090-4295(00)00491-x
[PubMed] [CrossRef] [Google Scholar]

54.
Rothlin CV, Ghosh S, Zuniga EI, Oldstone MB, Lemke G. TAM receptors are pleiotropic inhibitors of the innate immune response. Cell (2007) 131:1124–36.   10.1016/j.cell.2007.10.034
[PubMed] [CrossRef] [Google Scholar]

55.
Fenner JE, Starr R, Cornish AL, Zhang JG, Metcalf D, Schreiber RD, et al.. Suppressor of cytokine signaling 1 regulates the immune response to infection by a unique inhibition of type I interferon activity. Nat Immunol (2006) 7:33–9.   10.1038/ni1287
[PubMed] [CrossRef] [Google Scholar]

56.
Piganis RA, De Weerd NA, Gould JA, Schindler CW, Mansell A, Nicholson SE, et al.. Suppressor of cytokine signaling (SOCS) 1 inhibits type I interferon (IFN) signaling via the interferon alpha receptor (IFNAR1)-associated tyrosine kinase Tyk2. J Biol Chem (2011) 286:33811–8.   10.1074/jbc.M111.270207
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

57.
Bjorvatn B. Mumps virus recovered from testicles by fine-needle aspiration biopsy in cases of mumps orchitis. Scand J Infect Dis (1973) 5:3–5.   10.3109/inf.1973.5.issue-1.02
[PubMed] [CrossRef] [Google Scholar]

58.
Weis W, Brown JH, Cusack S, Paulson JC, Skehel JJ, Wiley DC. Structure of the influenza virus haemagglutinin complexed with its receptor, sialic acid. Nature (1988) 333:426–31.   10.1038/333426a0
[PubMed] [CrossRef] [Google Scholar]

59.
Li W, Hulswit RJG, Widjaja I, Raj VS, McBride R, Peng W, et al.. Identification of sialic acid-binding function for the Middle East respiratory syndrome coronavirus spike glycoprotein. Proc Natl Acad Sci U S A (2017) 114:E8508–17.   10.1073/pnas.1712592114
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

60.
Tan CW, Huan Hor CH, Kwek SS, Tee HK, Sam IC, Goh ELK, et al.. Cell surface alpha2,3-linked sialic acid facilitates Zika virus internalization. Emerg Microbes Infect (2019) 8:426–37.   10.1080/22221751.2019. 1590130
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

61.
Kubota M, Takeuchi K, Watanabe S, Ohno S, Matsuoka R, Kohda D, et al.. Trisaccharide containing alpha2,3-linked sialic acid is a receptor for mumps virus. Proc Natl Acad Sci U S A (2016) 113:11579–84.   10.1073/pnas.1608383113
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

62.
Kubota M, Okabe I, Nakakita SI, Ueo A, Shirogane Y, Yanagi Y, et al.. Disruption of the Dimer-Dimer Interaction of the Mumps Virus Attachment Protein Head Domain, Aided by an Anion Located at the Interface, Compromises Membrane Fusion Triggering. J Virol (2020) 94:e01732–19.   10.1128/JVI.01732-19
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

63.
Wang F, Chen R, Jiang Q, Wu H, Gong M, Liu W, et al.. Roles of Sialic Acid, AXL, and MER Receptor Tyrosine Kinases in Mumps Virus Infection of Mouse Sertoli and Leydig Cells. Front Microbiol (2020) 11:1292.   10.3389/fmicb.2020.01292
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

64.
Kubota M, Matsuoka R, Suzuki T, Yonekura K, Yanagi Y, Hashiguchi T. Molecular Mechanism of the Flexible Glycan Receptor Recognition by Mumps Virus. J Virol (2019) 93:e00344–19.   10.1128/JVI.00344-19
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

65.
Deng T, Chen Q, Han D. The roles of TAM receptor tyrosine kinases in the mammalian testis and immunoprivileged sites. Front Biosci (Landmark Ed) (2016) 21:316–27.   10.2741/4390
[PubMed] [CrossRef] [Google Scholar]

66.
Bhattacharyya S, Zagorska A, Lew ED, Shrestha B, Rothlin CV, Naughton J, et al.. Enveloped viruses disable innate immune responses in dendritic cells by direct activation of TAM receptors. Cell Host Microbe (2013) 14:136–47.   10.1016/j.chom.2013.07.005
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

67.
Shimojima M, Takada A, Ebihara H, Neumann G, Fujioka K, Irimura T, et al.. Tyro3 family-mediated cell entry of Ebola and Marburg viruses. J Virol (2006) 80:10109–16.   10.1128/JVI.01157-06
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

68.
Shibata T, Habiel DM, Coelho AL, Kunkel SL, Lukacs NW, Hogaboam CM. Axl receptor blockade ameliorates pulmonary pathology resulting from primary viral infection and viral exacerbation of asthma. J Immunol (2014) 192:3569–81.   10.4049/jimmunol.1302766
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

69.
Richard AS, Shim BS, Kwon YC, Zhang R, Otsuka Y, Schmitt K, et al.. AXL-dependent infection of human fetal endothelial cells distinguishes Zika virus from other pathogenic flaviviruses. Proc Natl Acad Sci U S A (2017) 114:2024–9.   10.1073/pnas.1620558114
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

70.
Wang H, Chen Y, Ge Y, Ma P, Ma Q, Ma J, et al.. Immunoexpression of Tyro 3 family receptors–Tyro 3, Axl, and Mer–and their ligand Gas6 in postnatal developing mouse testis. J Histochem Cytochem (2005) 53:1355–64.   10.1369/jhc.5A6637.2005
[PubMed] [CrossRef] [Google Scholar]

71.
Pickar A, Xu P, Elson A, Zengel J, Sauder C, Rubin S, et al.. Establishing a small animal model for evaluating protective immunity against mumps virus. PloS One (2017) 12:e0174444.   10.1371/journal.pone.0174444
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

72.
Wang XX, Ying P, Diao F, Wang Q, Ye D, Jiang C, et al.. Altered protein prenylation in Sertoli cells is associated with adult infertility resulting from childhood mumps infection. J Exp Med (2013) 210:1559–74.   10.1084/jem.20121806
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

73.
Sadler AJ, Williams BR. Interferon-inducible antiviral effectors. Nat Rev Immunol (2008) 8:559–68.   10.1038/nri2314
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

74.
Apari P, de Sousa JD, Muller V. Why sexually transmitted infections tend to cause infertility: an evolutionary hypothesis. PloS Pathog (2014) 10:e1004111.   10.1371/journal.ppat.1004111
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

75.
Kumar H, Kawai T, Akira S. Pathogen recognition by the innate immune system. Int Rev Immunol (2011) 30:16–34.   10.3109/08830185.2010. 529976
[PubMed] [CrossRef] [Google Scholar]

76.
Guazzone VA, Jacobo P, Theas MS, Lustig L. Cytokines and chemokines in testicular inflammation: A brief review. Microsc Res Tech (2009) 72:620–8.   10.1002/jemt.20704
[PubMed] [CrossRef] [Google Scholar]

77.
Wileman T. Autophagy as a defence against intracellular pathogens. Essays Biochem (2013) 55:153–63.   10.1042/bse0550153
[PubMed] [CrossRef] [Google Scholar]

78.
Spencer JV, Religa P, Lehmann MH. Editorial: Cytokine-Mediated Organ Dysfunction and Tissue Damage Induced by Viruses. Front Immunol (2020) 11:2.   10.3389/fimmu.2020.00002
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

79.
Diemer T, Hales DB, Weidner W. Immune-endocrine interactions and Leydig cell function: the role of cytokines. Andrologia (2003) 35:55–63.   10.1046/j.1439-0272.2003.00537.x
[PubMed] [CrossRef] [Google Scholar]

80.
Suh JH, Gong EY, Hong CY, Park E, Ahn RS, Park KS, et al.. Reduced testicular steroidogenesis in tumor necrosis factor-alpha knockout mice. J Steroid Biochem Mol Biol (2008) 112:117–21.   10.1016/j.jsbmb.2008.09.003
[PubMed] [CrossRef] [Google Scholar]

81.
Wang F, Liu W, Jiang Q, Gong M, Chen R, Wu H, et al.. Lipopolysaccharide-induced testicular dysfunction and epididymitis in mice: a critical role of tumor necrosis factor alphadagger. Biol Reprod (2019) 100:849–61.   10.1093/biolre/ioy235
[PubMed] [CrossRef] [Google Scholar]

82.
Theas MS, Rival C, Jarazo-Dietrich S, Jacobo P, Guazzone VA, Lustig L. Tumour necrosis factor-alpha released by testicular macrophages induces apoptosis of germ cells in autoimmune orchitis. Hum Reprod (2008) 23:1865–72.   10.1093/humrep/den240
[PubMed] [CrossRef] [Google Scholar]

83.
Hughes EG. The effectiveness of ovulation induction and intrauterine insemination in the treatment of persistent infertility: a meta-analysis. Hum Reprod (1997) 12:1865–72.   10.1093/humrep/12.9.1865
[PubMed] [CrossRef] [Google Scholar]

84.
Siu MK, Lee WM, Cheng CY. The interplay of collagen IV, tumor necrosis factor-alpha, gelatinase B (matrix metalloprotease-9), and tissue inhibitor of metalloproteases-1 in the basal lamina regulates Sertoli cell-tight junction dynamics in the rat testis. Endocrinology (2003) 144:371–87.   10.1210/en.2002-220786
[PubMed] [CrossRef] [Google Scholar]

85.
Siemann DN, Strange DP, Maharaj PN, Shi PY, Verma S. Zika Virus Infects Human Sertoli Cells and Modulates the Integrity of the In Vitro Blood-Testis Barrier Model. J Virol (2017) 91:e00623–17.   10.1128/JVI.00623-17
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

86.
Yule TD, Montoya GD, Russell LD, Williams TM, Tung KS. Autoantigenic germ cells exist outside the blood testis barrier. J Immunol (1988) 141:1161–7. [PubMed] [Google Scholar]

87.
Liu M, Guo S, Hibbert JM, Jain V, Singh N, Wilson NO, et al.. CXCL10/IP-10 in infectious diseases pathogenesis and potential therapeutic implications. Cytokine Growth Factor Rev (2011) 22:121–30.   10.1016/j.cytogfr.2011.06.001
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

88.
Krause KK, Azouz F, Shin OS, Kumar M. Understanding the Pathogenesis of Zika Virus Infection Using Animal Models. Immune Netw (2017) 17:287–97.   10.4110/in.2017.17.5.287
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

89.
Li N, Wang T, Han D. Structural, cellular and molecular aspects of immune privilege in the testis. Front Immunol (2012) 3:152.   10.3389/fimmu.2012.00152
[PMC free article] [PubMed] [CrossRef] [Google Scholar]

Mumps (epidemic)

Mumps is an acute infectious disease caused by a virus of the paramyxovirus family. The main signs of the disease are intoxication and inflammation of the parotid salivary glands. In some cases, other organs may be involved in the pathological process: the nervous system, testicles, pancreas. After the disease, in almost all cases, stable lifelong immunity is formed.

There is a vaccine against mumps that can significantly reduce the risk of infection, and before the introduction of mass vaccination it was widely available. Now outbreaks of infection are rare in developed countries. Most often, children aged 2-12 years get sick, although recently the percentage of adults has increased among the sick – those who were not vaccinated in a timely manner and who did not develop a sufficiently strong immunity as a result of vaccination.

The prognosis for mumps is generally good. Complications are quite rare and in most cases do not lead to irreversible pathological changes. However, mumps can sometimes cause infertility, deafness, and neurological problems.

Russian synonyms

Mumps, mumps, mumps.

English synonyms

Parotitis, mumps.

Symptoms

The initial stages of the disease are characterized by non-specific symptoms of general intoxication. About 20% of patients experience almost no discomfort – the disease can proceed unnoticed. The most characteristic sign of mumps – inflammation of the parotid salivary glands – develops only on the third day of the disease or may be completely absent.

The main symptoms of mumps are:

• fever,
• malaise,
• loss of appetite,
• swelling, soreness in the parotid salivary gland on one or both sides, which are aggravated by chewing, drinking acidic drinks, talking.

General information about the disease

The mumps virus belongs to the paromyxovirus family and resembles the influenza virus in structure. It consists of a single-stranded RNA surrounded by a glycoprotein envelope.

You can become infected from an infected person through airborne droplets. The virus is unstable in the external environment. The incubation period, that is, the time between contact with the source of infection and the onset of symptoms, is 2-3 weeks. A sick person is contagious already two days before the first symptoms and about a week after they appear. Uncomplicated parotitis usually lasts about seven days, rarely up to ten.

Children aged 2-12 are most affected by mumps. During the first year of life, the child’s body is usually protected by maternal antibodies. At the same time, the disease is more severe in adults.

The onset of mumps is usually accompanied by non-specific symptoms: fever, muscle pain, weakness, loss of appetite. The temperature is highest on the second day of illness. On the third day, 95% of patients experience swelling, pain in the parotid salivary glands, after which the manifestations of general intoxication begin to subside. Swelling of the salivary glands persists for up to 10 days. Inflammation of the parotid salivary glands can be one- or two-sided, the pain is aggravated by chewing, swallowing. The skin over the glands is tense. Soreness is especially pronounced with pressure in front of the earlobe and behind it, as well as in the region of the mastoid process. There is also a symptom of Mursu – inflammation in the area of ​​​​the excretory duct of the gland. The swelling can also spread to the neck area.

Complications of mumps are rare. Most often, the following violations occur.

• Damage to the nervous system – encephalitis and meningitis. Mild forms of neurological disorders are observed in 10% of patients with parotitis, but in the vast majority of cases they are completely curable and do not lead to severe consequences.
• Sensorineural deafness. Reversible hearing impairment develops in 4% of patients, but irreversible deafness is much less common and more often unilateral.
• Orchitis is an inflammation of the testicles that affects 20-50% of patients with mumps. Atrophic changes of varying degrees in testicular tissue occur in a third of patients, and fertility (the ability to conceive) may decrease, but infertility as a result of mumps is rare.
• Oophoritis – inflammation of the ovaries. It is very rare and does not lead to a decrease in fertility.
• Pancreatitis – inflammation of the pancreas. It affects 5% of patients with mumps. Changes in the pancreas are rarely irreversible, but a few cases of diabetes mellitus have been identified against the background of damage to the cells of the pancreas by the virus.

In addition to the mumps virus, inflammation of the parotid salivary glands can be caused by cytomegalovirus, influenza and parainfluenza viruses, HIV infection, various bacteria, in addition, it can be associated with metabolic disorders, neoplasms, salivary stone disease, and taking a number of medications.

Who is at risk?

• Children aged 2 to 12.
• Elderly people.
• Immunocompromised patients.
• Those who have not been vaccinated or who have not developed a sufficient level of immunity after vaccination.

Diagnosis

Diagnosis of mumps is based primarily on the history and symptoms present. Additional diagnostic measures may be required to exclude other diseases with a similar clinical picture.

Laboratory diagnostics

• Complete blood count (without leukocyte formula and ESR). Leukocyte formula. In mumps, leukopenia with relative lymphocytosis can be detected.
• Erythrocyte sedimentation rate (ESR). This is a non-specific sign of inflammation. With parotitis, it is increased.
• C-reactive protein. With parotitis, it is sometimes elevated.
• Total amylase in daily urine and total amylase in serum. Amylase is an enzyme produced by the pancreas and salivary glands. It is necessary for the digestion of carbohydrates contained in food. With pathology of the salivary glands or pancreas, the level of amylase in the blood and urine may be increased.
• Pancreatic amylase. Increased with damage to the pancreas.
• Determination of antibodies to the mumps virus in the blood. Class M immunoglobulins and class G immunoglobulins to the mumps virus are detected. IgM are responsible for the primary immune response and appear in the blood in the first days of illness. IgG begin to be produced a little later.

Other research methods

• Radiography (sialography), computed tomography, magnetic resonance imaging of the salivary glands. These methods allow assessing the state of the glands, identifying neoplasms, salivary stones, violations of the secretion outflow, pathological changes in the tissues of the salivary gland or surrounding areas.
• Testicular ultrasound. May be required for orchitis.

In case of complications, the doctor may prescribe a number of additional tests.

Treatment

There is no specific treatment for mumps, therapy is prescribed depending on the symptoms. Of great importance is bed rest, which reduces the risk of complications several times. Patients with complications, severe concomitant diseases, as well as all male patients over 12 years of age are subject to hospitalization.

Prevention

Prevention of mumps consists in timely vaccination. It is carried out for all children aged 12-15 months, as a rule, as part of a comprehensive vaccination against measles, rubella and mumps. Re-vaccinate against mumps at the age of 4-6 years.

Recommended tests

• CBC
• Leukocyte formula
• Erythrocyte sedimentation rate (ESR)
• C-reactive protein, quantitatively
• Total amylase in daily urine
• Total amylase in serum
• Mumps Virus, IgM
• Mumps Virus, IgG

Orchitis – causes, symptoms, diagnosis, prevention and treatment

Synonyms

Separate the acute and chronic forms of testicular inflammation. In the acute course of the disease, there is a sharp pain in the affected testis, high temperature up to 39-40 degrees and general symptoms of inflammation. With the transition of orchitis into a chronic form, the symptoms are mild, pain in the testicle occurs periodically, at a certain position of the body.

The inflammatory process can develop actively and affect adjacent epididymis. In this case, a separate disease with similar symptoms is diagnosed – epididymitis. If the cause of this pathology is originally orchitis, then the diagnosis is orchiepididymitis.

General information

The testicles are the male sex glands, located in the scrotum. The main functions of the organ are spermatogenesis and the production of hormones: testosterone, androstenedione, a small amount of progestins and estrogens. The external location of the testes is caused by the peculiarity of the maturation of spermatozoa, which require a temperature a fraction of a degree lower than in the abdominal cavity.

The glands are oval in shape, dense in structure and protected by a fibrous sheath. The testicles are connected to the penis by the spermatic cord, and in the scrotum are supported by muscles that can raise or lower the testes. The glands have a spongy structure, consist of cone-shaped lobules, each of which contains from 1 to 4 seminiferous tubules. These structures are in a folded state and have a length of up to 1 meter with a diameter of not more than 250 microns. In the tubules are the elements for the formation of spermatozoa. The tubules unite into ducts, which through the protein membrane are connected to the epididymis.

The inflammatory process of the testis is caused by infections, in 60% of cases these are pathogenic microorganisms that cause sexually transmitted diseases. Orchitis is also caused by other uropathogens that lead to urological diseases. The infection penetrates the structure of the testicles, causes an inflammatory process, which is expressed in the compaction of the glands and the appearance of swelling of the scrotum.

Statistics

Orchitis is of great social importance, since in a neglected state it leads to reduced fertility and infertility. The disease develops in men of all ages. At an early age, the cause of the pathology becomes a virus that causes mumps (mumps). Orchitis is registered in 80% of children who have been diagnosed with parotitis. In adult men, mumps leads to inflammation of the testicles in 20-25% of patients. To prevent the development of mumps allows vaccination at the age of 1-1.5 years.

The most commonly diagnosed unilateral orchitis is in 65-67% of cases. Bilateral is registered two times less often. Unilateral testicular inflammation reduces fertility in 25% of patients, bilateral orchitis in 60-65%. The peak of the disease occurs in men aged 20-30 years. During this period of active sexual life, there is a high risk of infection leading to sexually transmitted diseases and orchitis. At the age of 35-50, the number of cases of inflammation of the testicles decreases, and after 50 years, an increase in diseases begins. This is due to disorders of the genitourinary system of an elderly man.

Geographical and seasonal factors do not affect orchitis statistics. The prevalence of the disease does not depend on urban characteristics. A high percentage of cases is observed in countries with a low standard of living and the development of medicine. This is due to the lack of vaccinations against mumps, the wide spread of venereal diseases.

Orchitis is a curable disease with a high remission rate. Pathology with timely access to a doctor does not lead to infertility, is not a factor that causes benign or malignant tumors.

Specialized clinics

A-Line on Akademika Yangel

Close to metro

Parking available

Performs diagnostics

House call

Emergency 9 0003

Admits children

Admits pregnant women

Sick leave

camp

Accepts cards

Bonus program at the clinic

Vitbiomed+ Clinic on Oktyabrskaya

SHIFA on Lomonosovsky

There is a pharmacy

Accepts cards

Sick leave

Inquiries to the camp

Accepts children

Accepts pregnant women

Emergency care

You house calls

Own laboratory

Performs diagnostics

Equipped for the disabled

Yes parking

Close to metro

Premium clinic

Mira Clinic Adult department

Performs diagnostics

Accepts children

Accepts pregnant women

Accepts cards

Bonus program at the clinic

Apollonia Med on Chertanovskaya

Medline Service m. Annino

M C Clinic of Practical Medicine on Dynamo

Medical Center Stolitsa on Arbat

Causes

Causes of pathology can be divided into two groups of factors:

• pathological – the inflammatory process begins with mumps, brucellosis, typhoid fever, venereal diseases. Pathology is a complication of diseases such as malaria, epidemic hepatitis, pneumonia, scarlet fever, rheumatism, chickenpox. Orchitis develops with pathologies of the genitourinary system, tuberculosis;

• physical – testicular herbs lead to the disease, in which the protective membrane of the gland or the urethra is damaged. Among other reasons – prolonged mechanical compression of the spermatic cord, hematoma of the scrotum.

The development of the disease is facilitated by a weakened immune system, fatigue syndrome, stressful situations.

Symptoms of orchitis

Acute orchitis develops within 4-7 days, the disease has the following clinical picture:

• sharp pain in the testicle, which is aggravated by walking or by increasing physical exertion;

• increased body temperature;

• pain radiates to the groin or lower back;

• the affected testicle increases in size, the skin on the scrotum on its side becomes smooth, redness is observed;

• chills, fever;

• headache.

If the symptoms are not addressed, the lesion will affect the second testicle within 1-4 days.

With improper treatment of acute orchitis, the disease becomes chronic. The pain becomes episodic, manifests itself weakly, but fertility appears, sexual desire decreases. Chronic orchitis can cause a number of serious complications.

Pain while urinating

High temperature or fever

Headache

Lower abdominal pain

Urinary retention

Frequent urination

Sharp pain in the testicle

Testicular tumor

Change in the size of the testicles

Which doctor treats

Orchitis is treated by a urologist. Before visiting the doctor, it is necessary to take a shower, wear loose clothing that can be easily removed or put on. The appointment begins with the collection of anamnesis. The doctor specifies the date of appearance of the first symptoms, the nature of the pain, the presence of concomitant diseases. The patient’s temperature and blood pressure are measured. The reception ends with an examination, during which the doctor determines the localization of the inflammatory process, the presence of complications by palpation. After making a preliminary diagnosis, the urologist appoints a series of studies that will help choose a treatment method.

Contact the right specialist right now

Parvina Dzhurabekovna Nuriddinova

Experience 6 years

Contact

Diagnosis of orchitis

Laboratory and instrumental studies allow the urologist to determine the cause diseases, choose a conservative or surgical method of treatment. The doctor prescribes to the patient:

• clinical blood test;

• bacteriological culture;

• urinalysis;

• antibiotic susceptibility testing;

• ultrasound examination of the scrotum.

Doppler imaging helps to rule out external causes of pain.

Treatment of orchitis

When choosing a treatment method, the doctor takes into account the symptoms and the degree of damage. With severe pain, analgesics, other painkillers and anti-inflammatory drugs are prescribed. When diagnosing purulent complications, pus is drained by surgical methods. With a strong destructive lesion of testicular tissues, it is removed.

When choosing a course of treatment, the cause that led to the disease is taken into account:

• pathological – the underlying disease that caused orchitis is stopped. The urologist involves the therapist, the venereologist to treatment. Antibacterial agents are prescribed after determining the pathogen using bacterial culture. To alleviate the patient’s condition, raise the scrotum with a bandage or suspensor. It is recommended to apply cold compresses to the affected area. After normalization of the condition, physiotherapy is prescribed. In chronic orchitis, the doctor prescribes glucocorticoid therapy, antibacterial drugs;

• physical – post-traumatic orchitis is characterized by pronounced local symptoms. The patient develops edema, hyperemia of the skin of the scrotum, severe pain. The damaged area can become a site of infection. Depending on the clinical picture, the doctor prescribes cephalosporins, amoxicillin, carbapenems. Non-steroidal anti-inflammatory drugs demonstrate good efficacy. If the inflammatory process is not aseptic in nature, then antibiotics are not used. In the infectious nature of the inflammation, empiric antibiotic therapy is prescribed.

The doctor recommends to patients a diet rich in collagen, protein, and vitamins.

The treatment is carried out on an outpatient basis, with a high temperature and the detection of tissue necrosis, the patient is placed in a hospital. With conservative methods of treatment, it is necessary to carefully consider the dosage of drugs. An overdose of antibiotics leads to dysbacteriosis, drowsiness, nausea, and can cause kidney and liver failure. Failure to comply with the recommendations in the treatment of analgesics can lead to increased blood pressure, tachycardia. After surgery, you must follow the rules of personal hygiene, change dressings regularly, and perform antiseptic treatment of the wound. If the recommendations are not followed, infection may begin.

If left untreated

If left untreated, inflammation of the appendages begins, followed by testicular abscess. With a late visit to the doctor, there is a high risk of atrophy, male infertility. Orchitis quickly progresses to a chronic stage, in which there is a decrease in fertility. In order to prevent relapse, timely treatment to the doctor is necessary.

If it is not possible to visit a urologist, it is necessary to use the possibilities of online medicine. This will require access to the Internet and a technical device with a video camera. Using a smartphone, tablet, laptop, a patient can receive a video consultation from an experienced urologist working in a metropolitan clinic or medical research institute. With the help of video communication, the doctor will collect an anamnesis, conduct an examination, and prescribe treatment. When choosing a therapy, the urologist will take into account the limited access to medicines. A timely visit to a doctor will help relieve symptoms, ensure a stable remission.

How to help yourself

When diagnosing orchitis, bed rest, wearing a bandage that supports the scrotum, and refraining from sexual intercourse is recommended. To reduce sexual excitability, which interferes with treatment, a decoction of hop flowers will help. A decoction of sweet clover, wintergreen, chamomile, knotweed and lingonberries will help relieve inflammation. St. John’s wort, cranberries, elderberry and chamomile give good results. It is recommended to make compresses from crushed flaxseed or cabbage leaves soaked in vinegar. To improve the state of the immune system, it is recommended to consume honey, foods high in vitamins.

Risks

Orchitis is not contagious but is caused by infections that can be passed from person to person. If left untreated, there is a high risk of infertility. Pathology can develop at any age. The following risk groups exist:

• small children not vaccinated against mumps;

• 90,002 promiscuous men;

• patients with infectious diseases;

• representatives of contact sports;

• 90,002 men over 50.

High risk of contracting an infectious disease that can lead to orchitis in immunocompromised people with chronic fatigue.

Prevention of orchitis

Orchitis develops quickly, easily passes into the chronic stage. For these reasons, it is recommended to pay more attention to the prevention of the disease. Preventing inflammation of the testicle is easier than curing the pathology and doing without serious consequences. It is recommended to maintain immunity, to refuse promiscuity. The following preventive measures are recommended for risk groups:

• young children should be vaccinated against mumps at the scheduled time;

• 90,002 promiscuous men are required to use condoms, which drastically reduce the risk of venereal disease;

• Patients with infectious diseases should undergo a course of treatment, during which – monitor their well-being and, at the first pain in the testicles, seek additional advice from a doctor;

• representatives of contact sports should use protective equipment, and in case of injury, seek medical attention;

• 90,002 men over 50 should be involved in the prevention of diseases of the genitourinary system.

With orchitis, prevention helps to avoid serious consequences, and timely medical care ensures a stable remission of the disease.

There are contraindications.