Cheek Swelling In A College Football Player - Page #4

Working Diagnosis:
Bilateral parotitis secondary to mumps virus infection

A cluster of 3 patients with similar symptoms had a confirmed diagnosis of mumps infection on our college campus. All patients recovered within 2 weeks with supportive care.

Author's Comments:
An active mumps viral infection causes fever, headache, myalgia, loss of appetite, and swollen glands and can lead to deafness, meningitis, and orchitis. These complications are lower in vaccinated patients. Recent mumps outbreaks in vaccinated populations were caused primarily by genotype G viruses, which are phylogenetically distinct from the genotype A vaccine strains. This could have reduced the efficacy of the vaccine against heterologous mumps viruses. Mumps antibody levels, post vaccination, decline with time. Therefore, it is recommended that a booster dose of MMR is recommended for adults who: were recently exposed to measles or are in an outbreak setting, were vaccinated previously with killed measles vaccine, are students in postsecondary educational institutions, work in a health care facility, or who plan international travel.
Mumps is a highly contagious disease. If a patient presents with symptoms similar to mumps, he should be treated as such until proven otherwise. A high index of suspicion and early intervention and quarantine are crucial in stopping the spread of the infection.

Editor's Comments:
Similar to mononucleosis, initial "negative" mumps screen should not dismiss the diagnosis. A high index of suspicion and early quarantine can prevent spread of this highly infectious condition.

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