Mumps ( Mumps ) symptoms
Mumps (Mumps) - an acute infectious viral disease, a disease of the salivary glands, particularly the parotid glands, which are located in the cavities under the auricles.First, fill the entire cavity of the gland, and then swollen face.At the same time it raised the pinna.If you hold your fingers under the jaw, can be felt solid tumor, which goes along it.This disease is accompanied by a lesion of glandular organs that have a common embryonic origin, and / or nervous system - the meninges, or peripheral nerves.
When the child has a swelling in the neck, always raises the question: pig (special disease of the parotid salivary glands) is either one of the other, a rare disease of the parotid glands (which may be repeated several times), or is it the usual swollen glands (lymphglands located on either side of the neck)?Normal lymph glands, sore throat swells after positioned below the neck and under the ear shells.The solid tumor is not held under the jaw.
When a child falls ill with mumps usually
There are other salivary gland, in addition to the parotid and sometimes pig and captures them.There submandibular gland situated below the lowermost part of the lower jaw.Sublingual gland is located behind the tip of the chin.Sometimes there are complications from mumps, and none of the salivary glands swell.
In mild form of mumps swelling disappears in three to four days.On average it lasts from a week to ten days.
Pathogen mumps epidemic - a virus belonging to the genus paramyxovirus, Sem.Of Paramyxoviridae, morphologically typical steam-miksovirusov large sizes (120-300 nm), rounded shape.Sheath layer 3 comprises - a membrane protein, a lipid layer and outer protrusions glycolipid.Single-stranded RNA is not segmented, it contains the RNA-dependent RNA polymerase.The nucleocapsid of the virus particle forms a core component of the soluble (5) - complement-antigen.It has hemagglutinating, hemolytic and neuraminidase activity.Virus detected in the early days of the disease in the saliva in the salivary gland specific antibodies appear in the blood.The immunity persists for a long time.
antigenic structure of the virus is stable.It contains antigens able to induce the formation of neutralizing, and complement-antihemagglutination antibody and allergen, which in some cases can be used for setting intracutaneous test.
virus is relatively stable in the environment, with 18- 20 ° C is maintained for several days at low temperatures - up to 6 months.Hemagglutinin, hemolysin and infectious virus activity is lost in the case of heating at 56 ° C for 20 minutes.And COP-allergen antigen are more stable to heat and can withstand temperatures of 65 ° C and 80 ° C and 30 min respectively.
attenuated vaccine virus is stored in the lyophilized state at least one year after dissolving loses activity over 8 hours at 40 ° C.
rapidly inactivated virus 1% Lysol solution, 2% solution of formalin, ultraviolet irradiation.
Epidemiology. source of infection is a symptomatic patient, and blurred shapes people.mumps virus begins to stand out with the saliva with a 4-6 day incubation period.After the 9th day from the moment the patient is considered to be non-contagious diseases.
main route of transmission - airborne.There is a possibility of infection through contaminated objects saliva.
virus infects mainly children, are near the source of infection.Joining respiratory infection facilitates the spread of mumps virus infection.
Susceptibility varies from 30 to 50%.The highest incidence occurs between the ages of 3 to 6 years.Children of the first year of life rarely get sick, because they get from mother transplatsentarno antiviral antibodies.
after previous infection formed a strong immunity.Repeated cases of disease do not occur.
class M immunoglobulins are found in the blood of the patient at the end of the first week of illness, and are recorded within 60-120 days.Somewhat later identified immunoglobulin class G, which grows to a titer of 3-4 weeks and persists throughout life.A role in the formation of immunity belongs to cellular immunity, and secretory immunoglobulin.
Mumps infection recorded throughout the year with a rise in the incidence of winter-spring period.
pathogenesis of mumps infection. entrance gate with mumps infection is the upper respiratory tract mucosa, where it is a reproduction and accumulation.Primary viremia may manifest clinically only defeat of the parotid salivary glands.Repeated more massive release of virus in blood (viremia secondary) causes damage many organs and systems of the nervous system, pancreas, gonads, and other glandular structures.Moreover, the corresponding clinical manifestations found in the later stages of the disease.
Pathological changes at a mumps infection.Morphological changes in mumps infection occur mainly in the interstitium of the salivary glands.Foci of inflammation are localized mainly around the excretory ducts, around the blood vessels.The glandular tissue organ in the pathological process is almost not involved.
However, when orchitis inflammatory degenerative changes can be quite pronounced, in fact, there may be foci of necrosis of glandular tissue with blocked tubules with subsequent atrophy of the testicles.
When meningitis observed brain swelling, redness, lymphocytic infiltration of the meninges.
case of suspected mumps need to call a doctor.It is important to accurately establish the diagnosis.If it turns out that the swollen lymph glands, the treatment will be different.
Child usually kept in bed until the swelling subsides.Some at the pig can not eat or drink anything acidic or tart, such as lemon juice (it hurts swollen glands), but others may have a meal.Therefore, the rejection of a lemon marinade or not an indicator of pigs.
incubation period for mumps infection is 11 to 23 days (average 15-19 days).Very rarely it is shortened to 9 days or be extended to 26 days.
for mumps flowing typically characterized by acute onset, body temperature rise to subfebrile or febrile digits, the appearance of symptoms of intoxication.
Occasionally observed prodromal period.In the last 1-2 days of the incubation period, there is a weakness, sleep disturbances, headache, pain in muscles and joints, the evening temperature rises.There may be loss of appetite, abdominal pain, vomiting, dry mouth, soreness at the projection of the affected gland - a symptom Filatov.
By the end of the first, at least the second day of onset appears parotid salivary glands.Typically the process begins with one hand and then through the second 1-2 day affected gland.This marked a new rise in body temperature.
inflammation of the parotid gland with mumps infection is accompanied by soft tissue swelling, which is located in front of the ear, in the top of the angle formed by the ascending branch of the mandible and the upper 1/3 of the sternocleidomastoid muscle.In the center of the elastic-elastic swelling, and to the periphery - paste-like consistency, so in most cases there are no clear boundaries it.The skin over it is not changed, palpation causes mild soreness.Sometimes edema spreads to the face, neck, subclavian area.Cases of its spread to the pharynx and larynx.
During the inspection of the inner surface of the cheek of the patient mumps can detect congestion and swelling of the mouth of the parotid duct - a symptom of Murcia (Moursou).Last it is not specific to mumps infection, but in combination with other symptoms establish a diagnosis, since there is already in the prodromal period.
submaksillita clinical picture. Submaksillit rarely the only manifestation of mumps infection and usually develops in the background of the existing lesions of the parotid gland.In the submandibular region appears rounded infiltrate doughy consistency, moderately painful on palpation.Under the tongue can be seen flushing and swelling of the mouth of the ductless glands affected.The development of the subcutaneous tissue edema, and spread it on the neck occurs in severe forms of the disease.
clinical picture orchitis
Men and boys during puberty mumps can spread to the testicles.It usually affects only one testicle.But even if both testicles are inflamed, it rarely leads to sterility (inability to have children).However, boys are preferred to have had mumps puberty, and some doctors recommend deliberate contamination.Teenagers and men should beware of infection.
Orchitis usually develops in boys older than 11 - 12 years.Its symptoms can appear on the 5-8th day of illness.At the same time observed a new rise in body temperature to 38-39 ° C, malaise, abdominal pain, radiating to the scrotum and testes, then the latter is growing rapidly, is sealed, there is a sharp pain.The skin of the scrotum becomes hard, congested, cyanotic.The most common complaints of the children show a feeling of heaviness in the testicle, pain, worse while walking and urinating.
often affects only the right testicle, which is associated with the peculiarities of blood supply.However, 15% of patients may be a two-way process.In addition, it may develop epididymitis.
expressed pathological changes in the testis persist for 5-7 days, then begins a slow recovery.Signs of atrophy of the organ observed in 1-2 months.The manifestations of left-orchitis are more resistant.
clinical picture of serous meningitis
Mumps sometimes causes a particular form of meningitis.The child has a fever, lose the flexibility of the neck, he raves.It is rarely dangerous.Infection of the pancreas can cause severe abdominal pain and vomiting.
Mumps - contagious disease.Some doctors, including myself, believe that it is possible to get sick again, so do not expose yourself to unnecessary risk.If a person has a tumor on both sides, it does not matter: he can still get sick again.
defeat meninges most often develops on 3-5 day from the moment of destruction of the salivary glands.At the same time against the backdrop of fading of symptoms of mumps are observed:
quickly appear meningeal signs: neck stiffness, symptoms and Brudzinskogo Kernig.However, some children may not meningeal signs ( "without meningitis meningitis").The presence of persistent focal symptoms indicating involvement in the pathological process of brain substance (meningoencephalitis).
diagnosis is confirmed by the results of a lumbar puncture.When mumps meningitis transparent liquor, it flows under pressure observed lymphocytic pleocytosis (hundreds or thousands of cells), cell-protein dissociation, glucose and chloride does not differ from the norm.
usually favorable course of the disease, but the readjustment of liquor may occur within 3-5 weeks.
clinical picture of pancreatitis. Pancreatitis with mumps infection usually develops acutely, on 5-9 day from the beginning of the disease.At the same time observed:
In young children may appear greasy stools, older - constipation.On palpation of the abdomen, tenderness, bloating, positive symptoms Mayo-Robson and Resurrection.In biochemical blood analysis revealed a significant increase in the activity of amylase, lipase, trypsin.Diastase activity increased in urine.
Current favorable disease.Acute symptoms subside in 1 to 2 nd day of illness, the full restoration of pancreatic function occurs at 3-4 weeks.
Complications of mumps infection .Complications of mumps infection are rare.However, there may be pneumonia, deafness, persistent paresis or paralysis of the limbs, testicular atrophy, otitis media, sinusitis.
clinical picture polyneuropathy with mumps infection. defeat peripheral nerves with mumps infection is rare and may occur as the height of the disease, and in the period of convalescence.Thus, the parotid gland sometimes leads to compression of the facial nerve, which is accompanied by a violation of mimic muscles function.Polyradiculoneuropathy develop after decrease in acute manifestations of mumps infection and characterized by flaccid paralysis of the lower limbs, pain.In the cerebrospinal fluid is an increase in protein content and lymphocytic pleocytosis.
The disease is usually favorable.However, it may result in the cochlear nerve with permanent loss of hearing.
Syndromes mumps infection. addition obscheinfektsionnoy symptoms in the clinical picture of mumps infection may occur following syndromes:
differential diagnosis of mumps infection, taking into account sialoadenita syndrome.
When mumps in the list of communicable diseases subject to differential diagnosis by syndrome "sialadenitis", should include:
whereas among non-communicable diseases to be excluded, the most frequent:
symptoms that distinguish the secondary purulent parotitis on an epidemic.Since purulent Mumps is usually a complication of an infectious disease, in addition to signs of salivary gland lesions in a patient observed other symptoms characteristic of the primary infection.In addition, purulent mumps inherent pronounced local inflammatory changes: severe pain (pain until lockjaw), redness of the skin, thick consistency of the prostate, followed by the appearance of fluctuations, purulent discharge from the affected ductless glands.
In addition, hemogram occur leukocytosis with neutrophilic shift and accelerated ESR.
syndrome Differences Mikulic mumps .Mikulicz's syndrome in children is rare, most often affects those aged over 20 years.In this disease there is a bilateral lesion of the salivary and lacrimal glands.It is characterized by long duration, dry mouth, lack of fever, obscheinfektsionnoy symptoms, inflammation of the salivary glands.
Differences actinomycosis salivary glands from the mumps. disease is rare.It is characterized by gradual onset and prolonged course.The patient in the parotid or submandibular region appears tight, maloboleznenny infiltrate.At the same time there are no symptoms of fever and intoxication.Later in the gland develops necrosis, which is accompanied by fever, skin erythema, tenderness, followed by softening and the formation of long-term non-healing fistula with the Department of thick pus, which are defined by dense clumps (Druze actinomycete).Without specific treatment process is prolonged.
Differences ptyalolithiasis from mumps. When plugging in common lobular or parotid duct, an increase in its size, pain (salivary colic).After the drainage duct, said symptoms disappear, but may then reappear.Obscheinfektsionnye symptoms and inflammatory changes in the overall analysis of blood appear only in cases when there is a layering of secondary bacterial infection.
To detect stones in the ducts of the salivary glands may be used X-ray, ultrasound or computed tomography.