Mumps orchitis

Case report:

A 24 year old patient comes into practice and complains of pain, distension and significant swelling in both testicles. A few days earlier he had felt a malaise with muscle pain, body aches and night sweats as well as a swelling in both TMJ areas. Discomfort in urination, a stay abroad or unprotected sexual intercourse are denied a history.

Diagnosis:

On physical examination, initially falls on a bilateral doughy and pressure painful swelling of both parotid glands. Furthermore, there is a marked tenderness and swelling of both testes in inconspicuous epididymis and without increased urethral. The rectal examination is unremarkable, the body temperature is increased only slightly with 37.5 � C.

Pathogenesis:

Mumps, also known as epidemic parotitis, is a viral disease caused by the mumps virus. Approximately 30% of adult patients who develop mumps develop orchitis as a complication. Mumps is a paramyxovirus infection and may be accompanied by other complications such as neuritis, myocarditis, arthritis, keratitis, retinitis and nephritis. Even a meningoencephalitis as severe central nervous onset form of mumps infection is observed in one to three percent of all central nervous system manifestations. Diagnosis can be used for the serological detection of antibodies to KBR, the haemagglutination inhibition or neutralization test, but the method of choice today is the Elisa. The detection of specific IgM antibodies in a serum sample suggests an infection that no longer than back is generally a maximum of three months. In case of positive detection of IgG antibodies on the other hand must not be closed easily on a fresh mumps virus infection. Another laboratory study, which may indicate a mumps disease, is the increase in amylase in serum.

Therapy:

Mumps is a self-limiting viral infection. Specific treatment does not exist. In the present case, symptomatic treatment with local cooling and, if required also undertaken with analgesics. In general, the duration of clinically manifest disease is no longer than five to eight days. The importance of orchitis for a complete infertility is estimated today rather than low.