Treatment for Mumps with Parotid Swelling

Mumps is a self-limited viral illness requiring only supportive care—there is no specific antiviral treatment available. 1

Immediate Management Approach

Provide symptomatic relief as the cornerstone of treatment:

Administer acetaminophen or NSAIDs for pain control (parotid gland pain, headache) and fever reduction 1
Ensure adequate hydration, as parotid swelling makes swallowing uncomfortable and painful 1
Recommend soft foods and avoidance of acidic foods/beverages that stimulate salivary flow and worsen pain 1

Implement strict droplet precautions immediately:

Isolate the patient for 5 days after onset of parotid swelling, as patients are contagious from 7 days before through 8 days after parotitis onset 2, 1
Educate household members about transmission through respiratory droplets and direct contact with saliva 1
Report the case immediately to local and state health departments, as mumps is a reportable disease 3

Obtain laboratory confirmation to verify the diagnosis:

Collect specimens for mumps IgM antibody testing or viral isolation from buccal swab, as clinical diagnosis alone can be unreliable (one-third of clinically diagnosed cases lack serologic evidence of mumps) 3
Consider that parotitis has multiple infectious and non-infectious causes, making laboratory confirmation essential for accurate diagnosis 3

Actively surveil for serious complications that require specific intervention:

Assess for aseptic meningitis (occurs in 4-6% of cases): severe headache, neck stiffness, photophobia, altered mental status 2, 1
In postpubertal males, monitor for orchitis (occurs in 20-38% of cases): testicular pain and swelling, typically appearing 4-8 days after parotitis onset 3, 2, 1
Watch for pancreatitis: severe abdominal pain, nausea, vomiting 2, 1
Be alert for hearing loss, including sudden sensorineural deafness (occurs in 1 per 20,000 cases) 3, 2, 1
Monitor for encephalitis (rare but serious): seizures, paralysis, cranial nerve palsies 2, 1

Review vaccination history and outbreak context:

Document vaccination status, noting that even two doses of MMR vaccine provide only 88% protection, and vaccine failure can occur 3, 4, 2, 1
Identify and vaccinate susceptible contacts during outbreak situations to limit spread 3, 4

Avoid interventions without proven benefit:

Do not prescribe antibiotics, as mumps is viral and antibiotics are ineffective 1
Do not use antihistamines or decongestants, as these have no role in mumps treatment 3
Do not administer corticosteroids routinely for uncomplicated parotitis (corticosteroids are reserved for specific complications like facial nerve involvement) 4

Counsel patients on natural history:

Parotid swelling typically peaks at 1-3 days and resolves within 7-10 days 2, 5
Most cases are self-limited with complete recovery, though complications occur more frequently in adults than children 3, 2, 5, 6