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

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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.

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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.

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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.